What Is a Varicocele?
In all guys, there's a structure that contains arteries, veins, nerves, and tubes — called the spermatic cord — that provides a connection and circulates blood to and from the testicles. Veins carry the blood flowing from the body back toward the heart, and a bunch of valves in the veins keep the blood flowing one way and stop it from flowing backward. In other words, the valves regulate your blood flow and make sure everything is flowing in the right direction.

But sometimes these valves can fail. When this happens, some of the blood can flow in reverse. This backed-up blood can collect in pools in the veins, which then causes the veins to stretch and get bigger, or become swollen. This is called a varicocele (pronounced: var-uh-ko-seel).

What Are the Signs and Symptoms?
In most cases, guys have no symptoms at all. A guy might not even be aware that he has a varicocele. However, if there are symptoms, they tend to occur during hot weather, after heavy exercise, or when a guy has been standing or sitting for a long time. Signs include:

a dull ache in the testicle(s)
a feeling of heaviness or dragging in the scrotum
dilated veins in the scrotum that can be felt (described as feeling like worms or spaghetti)
discomfort in the testicle or on that particular side of the scrotum
the testicle is smaller on the side where the dilated veins are (due to difference in blood flow)

What Do Doctors Do?
It's a good idea to get a testicular exam regularly, which is normally part of a guy's regular checkup. In addition to visually checking for any unusual lumps or bumps, the doctor generally feels the testicles and the area around them to make sure a guy's equipment is in good shape and there are no problems.

A testicular exam may be done while a guy is standing up so that the scrotum is relaxed. (Some abnormalities like a varicocele can be more easily felt in a standing position.) The doctor checks things like the size, weight, and position of the testicles, and gently rolls each testicle back and forth to feel for lumps or swelling. The doctor also feels for any signs of tenderness along the epididymis, the tube that transports sperm from the testicles.

The spermatic cord is also examined for any indication of swelling. If the doctor suspects a varicocele, he or she might confirm suspicions by using a stethoscope to hear the blood flowing backward through the faulty veins or might even use an ultrasound, which can identify malfunction of the veins and also measure blood flow.

Do Varicoceles Cause Permanent Damage?
Although there is no way to prevent a varicocele, it usually needs no special treatment. A varicocele is usually harmless and more than likely won't affect a guy's ability to father a child. Some experts believe, though, that in some cases a varicocele might damage the testicle or decrease sperm production. In those cases, a doctor will probably recommend surgery.

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