Skip to main content
  • Patient Portal
  • Pay Bill
  • Request Appointment
MCHS_Logo_2024_BLACK
    • Services

      Featured Services

      • Cardiology (Heart)
      • Gastroenterology & Hepatology (Digestive Care)
      • Neurosurgery
      • Obstetrics & Gynecology (OB-GYN)
      • Oncology (Cancer)
      • Orthopedics & Orthopedic Surgery (Bones)
      • Primary Care
      • Spine Care
      • Sports Medicine
      • Surgery
      • Urology

      View all services
    • Providers
    • Locations

      Minnesota

      • Albert Lea
      • Austin
      • Belle Plaine
      • Blooming Prairie
      • Butterfield
      • Caledonia
      • Cannon Falls
      • Fairmont
      • Faribault
      • Lake City
      • Lake Crystal
      • Mankato
      • Montgomery
      • New Prague
      • Northfield
      • Owatonna
      • Plainview
      • Red Wing
      • Sherburn
      • St. James
      • St. Peter
      • Waseca
      • Waterville
      • Wells
      • Zumbrota

      Wisconsin

      • Arcadia
      • Barron
      • Bloomer
      • Chetek
      • Chippewa Falls
      • Eau Claire
      • Ellsworth
      • Glenwood City
      • Holmen
      • La Crosse
      • Menomonie
      • Mondovi
      • Onalaska
      • Osseo
      • Prairie du Chien
      • Rice Lake
      • Sparta
      • Tomah

      View map
    • Classes/Events
    • Blog
    • Wellness
    • Referrals
    Posted By
    David Yang, M.D.

    David Yang, M.D.

    Urology

    Recent Posts

    • Bearded man reading book
      Speaking of Health
      Young man's disease: Testicular cancer
      April 07, 2023
    • Person holding 2x4 and wearing safety glasses
      Speaking of Health
      Surgical options for urinary leakage in men
      March 22, 2023
    • Couple, one leaning on shoulder of the other
      Speaking of Health
      Can a vasectomy be reversed?
      December 19, 2022
    Featured Topics
    • Behavioral Health
    • Cancer
    • Children's Health (Pediatrics)
    • Exercise and Fitness
    • Heart Health
    • Men's Health
    • Neurosurgery
    • Obstetrics and Gynecology
    • Orthopedic Health
    • Weight-loss (Bariatric) Surgery
    • Women's Health
    Join our email newsletter
    Speaking of Health
    Monday, December 5, 2022

    Enlarged veins can cause pain, infertility

    Topics in this Post
    • Men's Health
    Bearded person wearing stocking cap

    Many people have heard of varicose veins before. But it's not just the leg veins that can become twisted, enlarged, and feel achy or itchy. Any vein can become varicose, including veins in the scrotum.

    About 30% of men have enlarged and twisted veins in their scrotums. These are called varicoceles. They develop when blood pools in the veins instead of circulating out of the scrotum.

    Scrotal varicocele illustration

    Varicoceles usually develop over time, beginning in puberty, but can occur at any age. It's more common to have a varicocele on the left side of the scrotum because of differences in the vein anatomy. In some patients, they can lead to impaired fertility.

    Varicoceles symptoms

    For many men, varicoceles cause no symptoms or discomfort. They may not even know they have the condition.

    Some signs of varicoceles may include:

    • Dull or aching testicle pain
      It's more pronounced when you're standing and less when lying down.
    • A mass in the scrotum
      It could look like a "bag of worms" if large enough, or only noticeable by touch.
    • Differently sized testicles
      Occasionally, the testicle with varicocele can be smaller than the unaffected testicle.
    • Infertility
      Challenges conceiving a child can occur due to varicocele's effect on sperm production.

    Difficulties with infertility

    Not all varicoceles cause infertility. It's estimated that 10% to 20% of men diagnosed with varicoceles have difficulties fathering a child. About 40% of men with fertility problems have a varicocele.

    Varicoceles can affect fertility because they can affect the temperature of the testicle. Sperm production is most efficient at a lower temperature, about 4 degrees lower than the average body temperature. This is why the scrotum and testicles are outside the body cavity. Pooling blood in a varicocele can heat the testicles above the optimal temperature, leading to lower sperm counts. Similarly, men with fertility challenges are told to avoid hot tubs and saunas. The cooler testicle temperatures are more conducive to a high sperm count.

    Microscopic surgery

    Varicoceles that aren't causing pain, discomfort or other symptoms don't need to be treated. However, surgery may be necessary for men with significant testicular pain or low sperm counts affecting fertility; or young boys with delays in testicle growth.

    Surgery aims to ligate the troublesome veins while preserving adequate blood flow through the arteries feeding the testicle. While the aim is to improve pain or fertility, the appearance of the varicocele may not change after surgery.

    One type of surgery to treat varicoceles is called microsurgical subinguinal varicocelectomy. During this procedure, the surgeon uses an operative microscope and a doppler probe to assess blood flow through the testicle. The enlarged veins are closed off while the arteries are protected. The procedure usually takes two hours in an operating room.

    A different procedure option is called embolization. A radiologist injects a coil or solution that scars and closes the troublesome veins, like leg varicose vein treatment.

    Most varicoceles develop slowly over time. Talk with your health care team if you have concerns about testicular pain or fertility, or if you have a sudden onset varicocele, as it could be a sign of other health conditions.

    David Yang, M.D., is a urologist in Mankato, Minnesota.

    Topics in this Post
    • Men's Health

    Related Posts

    Bruce Simones 2-for-1 surgery: Hernia repair and prostate cancer removal
    Medications above pill bottle Pharmacogenomics: Getting the right drug
    Barb Welch A new me: Learning to live well with chronic conditions
    Mayo Clinic Health System
    About Us
    Careers
    Volunteer
    Donate
    Contact Us
    Patient Care
    Patients & Visitors
    Classes & Events
    Mayo Clinic Connect
    Mayo Clinic
    Resources
    For Medical Professionals
    Community Resources
    Financial Assistance
    Price Transparency
    Press Room
    Compliance
    Notice of Nondiscrimination
    Notice of Privacy Practices
    No Surprises Act
    Terms of Use
    Manage Cookie
    Privacy Policy
    © 2018 - 2025 Mayo Clinic Health System