Scrotal Varicoceles are a Common Cause of Scrotal and Testicular Pain

by Alex Shteynshlyuger MD


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What are Varicoceles?

Scrotal varicoceles are dilated  veins that have lost their natural one-way flow mechanism; this allows blood to pool in the scrotum.

Complex relationship between scrotal varicoceles and testicular pain.

Complex relationship between scrotal varicoceles and testicular pain.

What are the Causes of Varicoceles?

Varicoceles are caused by failure of valves in veins to function properly. This is most commonly caused by excessive intra-abdominal pressure; in many cases the cause is not clear.

What are the Symptoms of Varicoceles?

Most of the time, varicoceles cause no symptoms and are detected only incidentally during a physical exam. Sometimes varicoceles may cause scrotal aches, discomfort and testicular pain. Many men describe the pain as discomfort that is worse when standing up, walking or working out and relieved lying down.   Varicoceles may also cause infertility in a minority of men and occasionally prevent testis from growing normally in adolescent men (teenagers).  Scrotal varicoceles can also lead to low testosterone levels or hypogonadism.

Who needs treatment for varicoceles?

  • Men and adolescent boys with symptoms often require treatment.
  • Men and boys with chronic scrotal pain and discomfort caused by varicoceles can be effectively treated with microscopic varicocelectomy.
  • Men with low  testosterone levels and obviously large varicoceles can often be treated effectively with microscopic varicocelectomy which offers leads to increased testosterone levels.
  • Men who have suboptimal semen parameters and varicoceles may benefit from varicocele repair.
  • Teenage and adolescent boys with varicocele causing decreased testicular growth often benefit from varicocele repair.

What are the Treatment Options for Scrotal Varicoceles?

Microscopic varicocelectomy, laparoscopic varicocelectomy as well as embolization are some of the common treatment options for varicoceles.

Varicocelectomy for Treatment of Chronic Testicular and Scrotal Pain.

Scrotal varicocele is one of the more common causes of chronic orchialgia or testicular pain and discomfort.  While there are many causes for scrotal and testicular pain, many causes are temporary, related to infection such as epididymitis, epididymo-orchitis, referred pain, musculoskeletal causes due to pulled ligaments or muscle.  These tend to disappear spontaneously over a period of a few weeks to a few months.

In men with persistent or recurrent scrotal or testicular pain that has been present for many months, if varicocele is present, treatment of varicocele with varicocelectomy has been shown to effectively treat testicular pain in the majority of men.  Among men with varicocele and scrotal pain, duration of pain greater than 3 to 6 months is the best predictor of successful outcome.  75-80% of men with varicoceles experience complete or partial resolution of scrotal pain after varicocele repair.

How soon after varicocele repair for testicular pain can a patient experiences improvement in pain?

Most men experience pain resolution shortly after the procedure.  Most men have some scrotal discomfort related to surgery for the first few weeks after surgery.  Most men benefit from microscopic varicocelectomy surgery will experience relief from scrotal pain within the first 4-6 weeks after surgery.


If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call  1-(646) 663-5747

We offer affordable, highest-quality urology care.


 

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