A varicocoele is an enlargement of the veins in the scrotum. It affects around 15–20% of men and up to 40% of men assessed for infertility. It is usually left-sided; an isolated right-sided varicocoele warrants imaging to exclude another cause.
CONDITIONS
Varicocoele
Symptoms
• Often no symptoms
• A dull, heavy or aching scrotal discomfort
• Worse with prolonged standing or exertion
• Sometimes found during a fertility assessment
How We Diagnose Varicocoele
• Clinical examination while standing and with a bearing-down (Valsalva) manoeuvre
• Scrotal ultrasound with colour Doppler if the examination is unclear
• Semen analysis if fertility is a concern
• Occasionally further imaging
How We Treat Varicocoele
• No treatment if there are no symptoms and fertility is unaffected
• Simple measures for comfort, such as scrotal support and pain relief
• Embolisation by interventional radiology
• Surgical repair – microsurgical inguinal varicocoelectomy if available
