A varicocele occurs when the valves within the veins along the spermatic cord don't work properly. The abnormal valves prevent normal blood flow and cause blood to backup, which dilates and enlarges the veins. (This is essentially the same process as varicose veins, which are common in the legs.)

Varicoceles usually develop slowly and may not have any symptoms. They are more common in men between 15 and 25 years old. Varicoceles are more common on the left side. Varicoceles are often the cause of infertility in men.

The sudden appearance of a varicocele in an older man may be caused by a kidney tumor that has affected the renal vein and altered the blood flow through the spermatic vein.

• Visible, enlarged, twisted veins in the scrotum
• Infertility
• A painless testicle lump, scrotal swelling, or bulge within the scrotum, more common on the left side

Varicoceles may be managed with a scrotal support. However, if pain continues or if infertility or testicular atrophy results, the varicocele may need to be surgically ligated (tied off).

Varicocelectomy, the surgical correction of a varicocele, is performed on an outpatient basis. The cut is usually made in the lower abdomen, although various techniques can be used. Ice packs should be kept to the area for the first 24 hours after surgery to reduce swelling. You will be advised to wear a scrotal support for some time after surgery.

Possible complications of this procedure include hematoma (blood clot formation), infection, or injury to the scrotal tissue or structures. In addition, injury to the artery that supplies the testicle may occur.

Call for an appointment with your health care provider if you discover a testicle lump or need to treat a diagnosed varicocele.