Last updated on May 21, 2026
If you’ve noticed discomfort in the testicles, visible veins in the scrotum or have concerns about fertility, you may have a varicocele. At Vein Doctors Sydney, we regularly see men seeking treatment for this condition and offer varicocele embolisation, a minimally invasive procedure that aims to alleviate the symptoms associated with a varicocele. In this article, we explain what a varicocele is, what causes it, the symptoms to watch for and the treatment options available.
What Is a Varicocele?
A varicocele is an enlargement of the veins within the scrotum, similar in nature to varicose veins that develop in the legs. These veins, known as the pampiniform plexus, become swollen and twisted when blood cannot flow efficiently, leading to pooling within the vessels. Varicoceles are a common condition, affecting around 15% of the general male population and up to 40% of men investigated for infertility.
Varicoceles most commonly develop on the left side of the scrotum. This is largely due to the angle at which the left testicular vein drains into the renal vein, which makes it more susceptible to increased pressure and valve dysfunction.
Key facts about varicoceles:
- Enlarged, twisted veins within the scrotum
- Caused by faulty or absent valves within the testicular veins
- Can affect blood flow, temperature regulation in the testes and sperm production
What Causes a Varicocele?
Varicoceles develop when the valves inside the testicular veins fail to function properly. In healthy veins, these valves open and close to keep blood moving in one direction, back towards the heart. When the valves are faulty or absent, blood flows backwards and pools within the scrotal veins, causing them to enlarge over time.
The increased pressure from pooling blood is what leads to the characteristic swelling and discomfort associated with the condition. The left testicular vein has a longer anatomical course and drains at a sharper angle, thereby increasing venous pressure. This predisposes it to valve failure and explains the higher incidence of varicoceles on the left side.
Symptoms of varicocele include testicular pain or discomfort, visible enlarged veins and scrotal swelling or heaviness.
Common Varicocele Symptoms
Varicoceles do not always cause noticeable symptoms, and many men are unaware they have one until it is identified during a fertility investigation or routine examination. When symptoms do occur, they can include the following:
Testicular Pain or Discomfort
A dull ache or feeling of heaviness in one or both testicles is one of the most commonly reported symptoms. The discomfort often worsens after prolonged standing or physical activity and tends to ease when lying down, as this position helps blood drain away from the affected area.
Visible or Enlarged Veins
In some cases, the enlarged veins are visible through the skin of the scrotum. When pronounced, they are sometimes described as resembling a bag of worms due to their twisted, rope-like appearance. This is most noticeable when standing or after physical exertion.
Scrotal Swelling or Heaviness
A general feeling of fullness, swelling or heaviness in the scrotum is common, particularly after long periods on your feet. This sensation may be mild in the morning and worsen gradually throughout the day.
Fertility Issues
Varicoceles are one of the most common correctable causes of male infertility. The pooling of blood raises the temperature within the scrotum, which can disrupt sperm production and reduce sperm quality, motility and count. Many men first discover they have a varicocele when investigating difficulties conceiving.
Testicular Shrinkage
In some cases, particularly in younger males, a varicocele can contribute to testicular atrophy, where the affected testicle becomes smaller than normal. This is thought to result from the combination of heat, reduced oxygen supply and hormonal disruption caused by impaired blood flow.
How Do Varicoceles Affect Fertility?
Varicoceles are known to affect male fertility, mainly due to temperature changes. The testes need to stay slightly cooler than body temperature to produce sperm effectively. When blood collects in a varicocele, it increases heat in the area, which can impact sperm health. Over time, this can have a significant impact on sperm health and hormonal function:
| Effect | Impact |
|---|---|
| Heat increase | Disrupts sperm production and maturation |
| Blood pooling | Reduces oxygen supply to testicular tissue |
| Hormonal disruption | May affect testosterone production over time |
The good news is that treating a varicocele, whether through embolisation or surgery, has been shown to improve sperm parameters in many men, and some go on to conceive naturally following treatment.
Varicoceles can affect male fertility as they increase heat in the area, disrupting sperm production and maturation.
When Should You See a Doctor?
While not all varicoceles require treatment, there are circumstances where seeking specialist advice is worthwhile. You should consider speaking to a doctor if you are experiencing:
- Ongoing or worsening testicular pain or discomfort
- Visible swelling or prominent veins in the scrotum
- Difficulty conceiving after 12 months of trying
- A noticeable difference in size between the testicles
- Symptoms that are affecting your daily comfort or quality of life
Early assessment allows for an accurate diagnosis and gives you a comprehensive range of options when it comes to treatment.
How Is a Varicocele Diagnosed?
If a varicocele is suspected, your doctor will typically recommend one or more of the following:
Physical Examination
A varicocele can often be detected during a physical examination, particularly when the patient is standing. Your doctor may ask you to perform a Valsalva manoeuvre (bearing down as if straining) to make the veins more prominent and easier to assess.
Ultrasound Imaging
A scrotal ultrasound is typically used to confirm a varicocele diagnosis. It can assess the size of the affected veins, measure blood flow and identify any associated abnormalities such as testicular atrophy.
Fertility Testing
If fertility is a concern, a semen analysis may be recommended to assess sperm count, motility and morphology. This helps determine whether the varicocele is having a measurable impact on reproductive function.
Varicocele Treatment Options
Surgical Repair (Varicoelectomy)
Varicocelectomy is the traditional surgical approach to treating a varicocele. It involves making one or more incisions to access and tie off the affected veins. While effective, it requires general anaesthesia, carries a risk of complications such as infection or fluid build-up around the testicle and involves a recovery period of several weeks.
Varicocele Embolisation
Varicocele embolisation is a minimally invasive procedure performed by Dr Ryan McConnell at Vein Doctors Sydney. Rather than making surgical incisions, the specialist guides a thin catheter through a small puncture in the skin to the affected veins. Embolic material is then delivered through the catheter to block blood flow through the abnormal vessels, causing them to shrink over time.
Key benefits of varicocele embolisation include:
- No surgical incision required
- Performed under local anaesthetic with sedation
- Most patients return to normal activities within a few days
- No visible scarring
As with all procedures, embolisation is not suitable for every patient, and a specialist assessment is needed to confirm whether it is the right approach for you.
How to Book an Appointment
At Vein Doctors Sydney, we are committed to providing comprehensive consultations and support for patients seeking treatment for a varicocele. For more information on our services or to schedule a consultation at our clinic, please contact our staff by calling us on (02) 9023 9970, via our online form or by sending us an email.
Frequently Asked Questions
Is a varicocele dangerous?
A varicocele is not life-threatening, but it can have a negative impact on quality of life and fertility if left untreated. In some men, it may also contribute to a gradual decline in testicular function over time, which is why early assessment and monitoring are recommended.
Can a varicocele go away on its own?
Varicoceles do not typically resolve on their own. While symptoms may fluctuate, the underlying venous dysfunction does not resolve on its own. If a varicocele is causing discomfort or affecting fertility, treatment is usually recommended to prevent further impact on testicular health.
Does a varicocele always cause infertility?
Not necessarily. Many men with varicoceles father children without difficulty. However, varicoceles are one of the correctable causes of male infertility and treating them has been shown to improve sperm quality in a significant proportion of men. If you are having difficulty conceiving, it is worth investigating whether a varicocele may be a contributing factor.
Is varicocele embolisation safe?
Varicocele embolisation is a well-established procedure. Serious complications are uncommon, and most patients undergo the procedure and recovery without significant issues. Your specialist will discuss the specific risks relevant to your situation at your consultation.
How long does recovery take after varicocele embolisation?
Most patients return to light activities within a couple of days and resume normal daily activities within a week. Full recovery, including any improvement in fertility-related parameters, may take several months as the body responds to the treatment over time.
This information is not intended to be used for diagnosis or treatment. It is aimed at presenting a perspective only and is not a substitute for a prescription. Anyone experiencing a medical condition should consult their doctor.
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