Varicocele is a condition characterized by the enlargement of veins within the scrotum, similar to varicose veins that can appear on the legs. This condition is significant as it can affect the temperature within the scrotum, potentially disrupting normal sperm production and testicular function, which can lead to male infertility. Varicocele is relatively common, occurring in about 15% of the male population, and is especially prevalent among men who face fertility issues.

The diagnosis of varicocele usually begins with a physical examination, where a doctor can feel the enlarged veins, especially when the patient is standing. Symptoms of varicocele may include visibly enlarged veins, a feeling of heaviness, or pain in the scrotum. Scrotal ultrasound is another useful diagnostic method that can help confirm the presence of varicocele and assess its size and impact on the surrounding tissue. In addition to ultrasound, Doppler ultrasound can be used to assess blood flow through the veins, helping identify abnormalities in circulation.

The treatment of varicocele depends on the severity of symptoms and the degree of impact on fertility. Treatment methods include conventional surgical procedures such as varicocelectomy, a procedure in which the abnormal veins are tied off to redirect blood flow to healthier veins. Surgery is usually performed on an outpatient basis, under local or general anesthesia. Microsurgical varicocelectomy is an approach that uses microscopic techniques for more precise tying of the veins, which reduces the chance of damaging surrounding structures and can improve outcomes in terms of restoring fertility.
Embolization is a minimally invasive procedure where material is inserted through the blood vessels to block the abnormal veins, thus eliminating the need for traditional surgery.
After treatment, it takes time to determine its impact on spermatogenesis and overall improvement in fertility. In many cases, an improvement in sperm quality may only be seen after several months. Treatment of varicocele can significantly increase the chances of improving a man’s reproductive health, and the decision on the best treatment should be made in collaboration with a male infertility specialist.