Varicocele is when veins in your scrotum swell and get larger. It’s a lot like a varicose vein that you get in your leg. It might feel like a bag of worms. It's like piles of testicles which don't bleed, but creat pain and problems in fertility.

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It usually shows up above one of your testicles, most often the left one. You can usually see it when you stand up, but not when you lie down.

It should be harmless, but it can be uncomfortable or painful. And it might affect your fertility or cause your testicles to shrink.

This condition is fairly common and usually affects young men. About 10 to 15 of every 100 men have this problem. It’s not uncommon for boys to develop varicoceles as they move through puberty.

Causes

It could be a problem with blood flow in the spermatic cord, which carries blood to and from your testicles. If valves inside the veins in the cord don’t work like they should, the blood backs up and the veins get wider.

Each testicle has a spermatic cord holding it up. The spermatic cord has veins, arteries, and nerves. The veins have valves that keep blood flowing in one direction -- toward the heart. If a valve in the spermatic cord doesn’t close the way it should, blood backs up and causes a varicocele.

When varicoceles happen in teen boys, it’s often because of the quick growth they undergo during puberty. The testicles need more blood than normal as they develop, and any kind of problem in the veins can keep the blood from getting where it needs to go

Symptoms

Varicoceles rarely hurt. You may not even know you have one until you or the doctor sees it.

If yours does cause pain, it might:

• Switch from dull to sharp
• Get worse when you stand or exert yourself, especially for a long time
• Become more intense as the day goes on
• Go away when you lie on your back
• You may also have problems fathering a child. Varicoceles are one of the most common causes of infertility in men. Treating your varicocele should improve your sperm and help with infertility issues.

Diagnosis

You and the doctor may be able to feel the mass easily. If not, the doctor might ask you to stand, take a deep breath, and hold it while you bear down. They’ll call this the Valsalva maneuver. It helps them feel enlarged veins.

If the exam isn’t enough to be sure, they might take an ultrasound of your scrotum. A scrotal ultrasound uses sound waves to take pictures of the inside of your body. The pictures can tell your doctor how large the veins in your scrotum are, how large your testicles are, and which direction the blood is flowing in your scrotal veins.

The size of the lump in your testicle helps your doctor classify your varicocele on a grading scale of 0-3. A Grade 0 is the smallest, and can be seen only with the help of an ultrasound. Grade 3 is the largest, and means your varicocele is big enough that it changes the shape of your scrotum.

Treatment:

Not all varicoceles require treatment. It’s mostly done if:

• 1. You’re in pain

• 2. You have problems fathering a child

• 3. You’re a boy whose left testicle is growing smaller than the right