Varicocele: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Varicocele?
A urologist, a doctor who treats the male reproductive system and the urinary tract, usually treats a varicocele. A radiologist, a doctor who uses imaging, may do a treatment called embolization. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is varicocele?
A varicocele is swelling of the veins inside the scrotum. The scrotum is the sac that holds the testicles. These veins run along the spermatic cord, the cord that holds up a man's testicles.
It is similar to varicose veins in the legs. Varicoceles are common. About 20-25% of adult men have one. They usually start at puberty and last for life unless they are treated. A varicocele is often harmless.
Symptoms
Some men have no symptoms. In most men, a varicocele will not cause any symptoms or problems. When symptoms do occur, they can include:
- Enlarged, twisted veins in the scrotum.
- A dull ache or discomfort.
- A painless lump, swelling, or bulge in the scrotum.
- Possible problems with fertility, or a lower sperm count.
The testicle on the side of the varicocele may be smaller than the one on the other side. A varicocele can lead to lower fertility or scrotal pain in some men. It does not cause other health problems.
Causes and who gets it
A varicocele forms when damaged valves inside the veins along the spermatic cord keep blood from flowing well. Blood backs up. This swells and widens the veins. The exact cause is unknown. A varicocele is a variation of normal anatomy that does not show until puberty, when the testicles grow and blood flow increases.
Most varicoceles develop slowly. They are more common in men ages 15 to 25. They are most often seen on the left side of the scrotum, but they can occur on either side or both sides.
One common idea is that the swollen veins raise the temperature of the scrotum. The extra heat can interfere with normal sperm making.
How doctors diagnose it
A doctor checks your groin, scrotum, and testicles. The doctor may feel a twisted growth along the spermatic cord. A varicocele is easiest to see when you stand. It is usually less clear when you lie down. Sometimes it cannot be seen or felt, especially when lying down.
An ultrasound is not required to diagnose a varicocele, but it may help in some men. You may also have an ultrasound of the kidneys. A varicocele that shows on ultrasound but cannot be felt is called a subclinical varicocele.
Treatment
Many varicoceles need no treatment. Men with a normal semen analysis, a test of sperm count and quality, do not need treatment. A subclinical varicocele does not need treatment. A jock strap or snug underwear may ease discomfort. Treatment should be considered when a man has pain, or when he has infertility with an abnormal semen analysis.
Surgery is the most common treatment. The surgery is called varicocelectomy. A urologist ties off the abnormal veins. This sends blood to normal veins. The operation can be done through a cut or through small cuts with a camera. It is done as an outpatient procedure, and you can leave the hospital on the same day.
An alternative to surgery is embolization, done by a radiologist. A small tube called a catheter is placed into a vein in the groin or neck. A tiny coil is passed through it into the varicocele. The coil blocks blood flow to the abnormal vein. This method also needs no overnight hospital stay. It uses a much smaller cut than surgery, so you heal faster.
After surgery, your sperm count will likely increase and it may improve your fertility. Two thirds of men see better semen analyses, and about 40% can achieve a pregnancy. Testicular wasting, called atrophy, does not improve in most cases unless surgery is done early in adolescence.
When to see a doctor
Contact your provider if you find a testicle lump or need to treat a diagnosed varicocele. See a doctor if the size of a testicle changes or if you have trouble with fertility. A varicocele that appears suddenly in an older man may be caused by a kidney tumor, so he should be checked.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either kind of doctor can examine you, order an ultrasound, and refer you to a urologist. They can also follow up after treatment.
Common questions
Does a varicocele need treatment?
Not always. A varicocele is often harmless and often does not need to be treated. Treatment should be considered when there is pain, or infertility with an abnormal semen analysis.
Can a varicocele cause infertility?
Yes, a varicocele can lead to lower fertility in some men. Less than half of men with a varicocele have a lower sperm count or quality. Men with a normal semen analysis do not need treatment.
Is a varicocele dangerous?
Usually not. In most men a varicocele will not cause symptoms or problems, and varicoceles do not cause other health problems. A sudden varicocele in an older man should be checked, because a kidney tumor can cause one.
Do I stay in the hospital after varicocele surgery?
No, you will be able to leave the hospital on the same day as your surgery. Embolization is also done without an overnight hospital stay.
Sources
- MedlinePlus - Varicocele
- American Society for Reproductive Medicine - Varicocele (patient fact sheet)
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
