What Is a Varicocele?

Few findings cause as much quiet worry — and as many wrong assumptions — as a varicocele. It's often discovered almost by accident, described in alarming terms online, and promptly linked in people's minds to infertility or something worse. The reality is usually calmer and more ordinary than the search results suggest. The recording at the top of this page, "Varicocele Surgery", runs 6 minutes 9 seconds and shows an operation to repair one, so let's sort the myths from the facts before you watch it.

Myth: it is a tumour or a blockage

Fact: a varicocele is neither. It's a widening of the small veins that drain blood away from a testicle — the same basic idea as a varicose vein in a leg, just in a different place. Those veins sit in the cord that supports the testicle, and when their one-way valves don't close as well as they should, blood pools a little and the veins stretch and feel fuller. Most varicoceles form on the left side, which comes down to how the left testicular vein is plumbed into the larger veins of the abdomen. Many cause no symptoms at all and are simply noticed on examination, sometimes described as feeling like a soft tangle above the testicle. A fluid swelling around the testicle is a different finding altogether — our guide to a hydrocele explains how that one works.

Myth: if you have one, you will feel it

Fact: plenty of people feel nothing. When a varicocele does make itself known, it's typically a dull, heavy ache in the scrotum that builds through the day, is worse after standing or exertion for a long stretch, and eases when you lie down — lying flat lets the pooled blood drain away. It may also be visible as slightly fuller veins when you're standing. What a varicocele does not usually do is cause sudden, severe pain. Pain that comes on hard and fast is a different kind of problem that needs prompt, same-day assessment — a twisted cord, covered in our article on testicular torsion, is the emergency clinicians worry about most in that situation.

Myth: a varicocele always means fertility trouble

Fact: the link is real but narrower than the myth. Because pooled blood can keep the scrotum slightly warmer than ideal, a varicocele is sometimes part of the picture when semen quality is reduced — and the second video on this page, "Microsurgical Varicocelectomy for Varicocele" (8 minutes 58 seconds), notes in its own description that repair is performed for patients with a varicocele alongside impaired semen parameters, testicular atrophy, or pain. But many men with a varicocele father children without any difficulty, and a varicocele found on its own, with normal examination and no symptoms, is often simply monitored. It is a finding to put in context, not a verdict.

How a clinician checks it

The examination is hands-on and usually brief. You'll typically be checked standing up, since a varicocele fills when you're upright and often empties when you lie down — that change is itself a useful clue. The clinician feels the cord above the testicle, may ask you to bear down briefly to make the veins fill, and compares both sides. An ultrasound scan is sometimes added, particularly if the examination is uncertain or the other side needs a closer look. Blood tests or semen analysis only enter the picture when there is a specific question about them — they're not automatic for everyone with the finding.

When repair enters the conversation

Plenty of varicoceles are left alone and simply kept an eye on. Repair is generally considered when there's persistent aching that doesn't settle, when a testicle is smaller on the affected side, or when a varicocele is part of a fertility assessment — the situations named in the microsurgical video linked above. The operations share one goal: closing off the widened veins so blood reroutes through normal channels. Approaches include open surgery, a laparoscopic (keyhole) route, and microsurgical repair of the kind in that second video, which uses magnification to work on the small veins in the cord. The anchor recording shows the operating side of that work rather than a consultation, so treat it as a view of the procedure itself — which approach, if any, fits your situation is a decision for an examination and a conversation with the treating team, not for a video page.

MedicalVideos.com has published trusted medical videos since 2007. The site was founded by Dr. Mohamed Ibrahim, MD, PhD — physician-scientist.

Frequently Asked Questions

Does a varicocele go away on its own?
No — once the veins have widened, a varicocele doesn't usually disappear by itself. But disappearing isn't the goal for most people: a varicocele that causes no pain, no change in testicle size, and no fertility concern is often simply monitored over time.

Can you feel a varicocele yourself?
Sometimes. It may feel like a soft, tangled fullness above the testicle, most noticeable when standing, and it often softens or empties when you lie down. Not every lump or fullness is a varicocele, though, so any new scrotal finding is worth having examined in person.

Why are varicoceles more common on the left?
It comes down to anatomy. The left testicular vein drains into a larger abdominal vein at a less favourable angle than the right, which makes its valves work harder and pooling more likely. Right-sided and both-sided varicoceles do occur and are examined in the same way.

Does every varicocele need surgery?
No. Surgery is one option, considered mainly for persistent pain, a smaller testicle on the affected side, or as part of a fertility assessment. Many varicoceles are managed with monitoring alone, and the decision is made with the treating team after examination.

Is a varicocele dangerous?
A typical varicocele is a benign vein finding, not a cancer and not an emergency. The exception to keep in mind is pain: sudden, severe testicular pain is not typical of a varicocele and should be assessed promptly, the same day.

Educational only — this article is general information about varicocele, not medical advice and not a diagnosis. Any new scrotal swelling or pain should be examined by a clinician, and sudden severe testicular pain should be assessed the same day.