A varicocele is an enlargement of the veins within the loose bag of skin that holds testicles (scrotum). Varicocele is a scrotal abnormality defined by elongated, dilated and tortuous veins that drain the testicle. Most varicoceles occur on the left side and the remainder on both sides. They are generally acquired during puberty. However, a varicocele in one testicle can affect sperm production in both testicles. The exact causes of varicoceles are not well understood. Some believe that the valves in the spermatic cords, those that carry blood to testicles are not working properly. In the same way that leads to the formation of varicose veins of the leg. One-way valves in the veins should always allow blood to flow toward the heart. If the valves fail, the blood flow is disrupted and can pool rather than move smoothly on. This build-up of blood causes a consequent dilation of the vessels. Most varicoceles are asymptomatic. However, they can be uncomfortable and cause scrotal pain. This pain is generally mild to moderate, occurs with continuous sitting, standing or activity and is relieved by lying down. Although it can be uncomfortable before bedtime (after a long day of activity), it generally does not occur upon awakening after a night’s rest. The pain is dull, congestive‚ like a toothache. It is not associated with urination issues or erectile dysfunction, however, it is associated with male infertility. Lastly, when large, a varicocele can cause a clumpy “bag of worms” feel in the scrotum and can be bothersome for this reason as well.
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