A varicocele is a cluster of dilated veins located next to the testicle, resembling a bag of worms. This diagnosis is typically non-harmful and painless. Varicoceles are common, occurring mainly on the left side. They most often develop during puberty, though they can also appear earlier. The most significant concern associated with varicoceles is the potential for decreased fertility later in life in some untreated patients.
What Are the Symptoms of Varicoceles?
Most children will not complain of symptoms and may not know they have a varicocele. However, if symptoms do present, they tend to occur during hot weather, after heavy exercise, or after standing or sitting for a long time.
Signs may include:
- Dull ache in the testicles
- Feeling of heaviness in the scrotum
- Dilated veins in the scrotum that can be felt (described as a bag of worms)
- The testicle is smaller on the side with dilated veins
How Is a Varicocele Diagnosed?
A varicocele is often detected through physical exam or by the patient himself. Pain is rarely associated with a varicocele.
Once the varicocele is found, a scrotal/testicular ultrasound may be ordered to assess the size of the testicles and the extent of the varicocele. In older children, the physician may suggest a semen analysis to evaluate whether there is a problem with fertility.
What Is the Treatment?
Varicocele treatment varies depending on the patient and the symptoms. If the child has no symptoms, and imaging or semen analysis are normal, the testicles may be evaluated yearly to ensure adequate growth. If the varicocele is hindering the development of the affected testicle, it may alter sperm quality and should be treated.
If your child is experiencing pain, the testicle is not growing adequately, or if the semen analysis is abnormal, surgical repair of the varicocele may be appropriate. The procedure to correct this is simple and outpatient – called a varicocelectomy. The procedure is performed in the operating room while the child is asleep under general anesthesia. A small incision is made in the affected testicle, and the vessels causing the problem are cut or tied off.
If you have any questions or concerns about pediatric varicoceles, schedule an appointment with an expert Georgia Urology pediatric urologist.