Testicular & Scrotal Conditions & Male Infertility
Varicocoele
A varicocoele is a collection of enlarged veins in the scrotum, similar to varicose veins in the legs. They are very common, usually harmless, but can sometimes cause a dull ache or affect fertility.
Key Takeaways
- A varicocoele is a collection of enlarged veins in the scrotum, similar to varicose veins in the legs. They are very common, usually harmless, but can sometimes cause a dull ache or affect fertility.
- We offer specialist diagnostics and treatments. Book a consultation to discuss your options.
Clinical Overview
Understanding Varicocoele
A varicocoele is a collection of enlarged, swollen blood vessels (veins) inside your scrotum—the loose bag of skin that holds your testicles. It is very similar to having varicose veins in your legs.
For many men and young boys, a varicocoele is entirely harmless and does not cause any discomfort. However, because blood can pool in these widened veins, it can sometimes lead to a heavy, dragging ache, visible swelling, or changes in sperm quality that may affect your ability to have children.
What to Look For
Symptoms, Causes & Risk Factors
01
Common Symptoms
Many men with a varicocoele will never experience any symptoms, and the condition is frequently found during a routine medical check. When symptoms do occur, they typically include:
A dull, heavy ache or dragging sensation in the scrotum, which often feels worse when you are standing up, exercising, or towards the end of a long day.
A visible or touchable swelling above your testicle that feels like a "bag of worms".
Scrotal discomfort that gets much better or disappears completely when you lie flat on your back.
02
When to Seek Help
You should book an appointment to see your GP if you notice any new lumps, changes in size, or persistent discomfort in your scrotum. While varicocoeles are usually completely safe, it is vital to have any scrotal swelling professionally checked to rule out more serious conditions.
When to get urgent medical attention: Please see a doctor urgently or visit your nearest NHS Urgent Treatment Centre or A&E department if:
A painful swelling suddenly appears in your scrotum.
The swelling does not shrink or go away when you lie flat.
You experience sudden, severe pain in your testicle (which can be a sign of a medical emergency called testicular torsion).
03
Potential Causes
A varicocoele happens because of a breakdown in how blood travels away from your testicles:
Faulty valves: The veins responsible for carrying blood back towards your heart contain tiny, one-way valves. If these valves become weak or fail, gravity pulls the blood backwards. The blood then pools in the scrotum, causing the veins to stretch and swell.
Natural anatomy: The veins on the left side take a longer, more vertical route to connect to the main kidney vein, which is why the vast majority of varicocoeles occur on the left testicle.
Pressure or blockages: In very rare cases, an unexpected blockage in the larger veins deep inside your tummy (abdomen) can cause back-pressure on the scrotal veins.
04
Risk Factors
Varicocoeles are incredibly common, affecting around 15 in every 100 men in the UK.
Age: They most frequently develop during puberty and early adulthood (between the ages of 15 and 25) when the testicles are growing quickly and require a substantial increase in blood supply.
Height: Taller men may have a slightly higher chance of developing a varicocoele due to their longer veins experiencing higher natural blood pressure.
Note: Activities like heavy lifting, cycling, or straining do not cause a varicocoele to form, though they can make an existing one feel more uncomfortable.
Importance of Diagnosis
Why Early Diagnosis Matters
Getting a professional diagnosis matters because it rules out other types of testicular lumps and gives you complete peace of mind. A simple, painless physical examination by a GP or a specialist urologist is usually all that is needed to confirm a varicocoele.
Furthermore, identifying a varicocoele early is highly important if you are experiencing fertility difficulties or if a teenager's testicle is shrinking or not growing properly. Early detection allows urologists to monitor your health and safeguard your long-term reproductive and hormone levels.
Importance of Diagnosis
Diagnostic Options & Investigations
To accurately identify the cause of your symptoms, our specialists use a range of targeted investigations. Explore the diagnostic tests below to understand how we confirm a diagnosis and plan your recovery.
Living With Condition
Living With Varicocoele
- Observation (monitoring the condition if it is small and causes no symptoms)
- Radiological embolisation (a minimally invasive X-ray procedure done under local anaesthetic to block the veins)
- Surgical repair (open microsurgical or laparoscopic keyhole surgery to tie or clip the veins)
For most men, living with a varicocoele is completely straightforward and requires no medical procedures. If you experience mild, occasional discomfort, you can manage it with these measures:
Wear supportive underwear: Swap loose boxer shorts for supportive briefs, cycling shorts, or a scrotal support ("jock strap"). This lifts the scrotum, reduces gravity's pull, and significantly eases that heavy sensation.
Use simple pain relief: Over-the-counter painkillers like paracetamol or ibuprofen can help soothe a dull ache after a busy day on your feet.
Sit down: Standing can make the dragging feeling of a varicocoele worse. Lie down or sit to reduce the discomfort.
Keep cool: Avoid long, hot baths, saunas, steam rooms or hot tubs.
Short-Term Complications
03- Mild scrotal discomfort
- Localised swelling or bruising
- Cosmetic anxiety or self-consciousness
Long-Term Complications
03- Testicular shrinkage (atrophy): In teenagers, a large varicocoele can stop the affected testicle from growing to its full, healthy size.
- Persistent chronic pain: If left unmanaged, a large varicocoele can lead to a long-term, frustrating ache that interferes with exercise, walking, or standing for long periods.
- Fertility issues (subfertility): The pooled blood can raise the temperature inside your scrotum, which can reduce your sperm count, movement, and overall sperm quality.
Treatment Options
Treatment Options & Care Pathways
Explore the specialist interventions available for Varicocoele. We offer a range of evidence-based treatments designed to address your specific symptoms, focusing on long-term recovery and your personal health goals.
Specialists
Our specialists for Varicocoele
Leading experts for this condition. View profiles to see clinical backgrounds and current availability.
Our Commitment
Care you can trust
Every step of your care is delivered to the same standard: senior consultants, a personalised plan, and the safety of an accredited private hospital behind you.
Consultant-Led Excellence
Receive evidence-based care delivered by senior NHS consultants in a professional, specialist setting.
Personalised Care Plans
Your consultant will design a bespoke plan tailored to your condition, health goals and lifestyle.
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A Heritage of Trust
Our partners bring decades of NHS and private experience, successfully managing thousands of patient cases.
Patient Guidance
Frequently Asked Questions
Common questions about specialist referrals and consultations.
2 questions
No, the vast majority of varicocoeles do not require any medical or surgical treatment. If your varicocoele is small, discovered incidentally during a routine check, and isn't causing you physical pain or fertility issues, it can be safely left alone.
Treatment is generally only recommended if you experience a persistent, troublesome ache that impacts your daily life, if you are experiencing fertility difficulties linked to poor sperm quality, or if a teenager's testicle is experiencing shrinkage (atrophy). If treatment is necessary, our specialists usually recommend a minimally invasive day-case procedure called varicocoele embolisation.
Reviewed 12 Jun 2026
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Healthy sperm production relies on the testicles remaining a few degrees cooler than the rest of the body. When a varicocoele forms, the faulty valves cause blood to pool and stagnate inside the scrotum. This pooled blood acts like a radiator, raising the local temperature around the delicate testicular tissue.
The higher temperature can over time disrupt sperm development, reducing your overall sperm count, impairing sperm movement, and causing hidden structural damage (Sperm DNA Fragmentation). In teenagers, this constant, elevated temperature and pooling of blood can also restrict healthy circulation, occasionally preventing a growing testicle from reaching its full, natural size.
Reviewed 12 Jun 2026
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