Varicoceles in Children

What are varicoceles in children?

A varicocele is when veins in the scrotum have become large and swollen (dilated). The condition is like varicose veins that occur in the legs.

When veins inside the spermatic cord aren't working correctly, the veins can swell. The spermatic cord joins each testicle to the body. Veins in the cord normally take blood back to the heart. Tiny valves inside the veins keep the blood flowing in the right direction. Valves that don't fully close let the blood flow slowly or pool inside the veins. This buildup of blood causes the veins to swell.

A varicocele most often occurs in the left testicle. This may be because of the angle at which blood from the scrotum enters the kidney veins. It can cause pressure to build up in the scrotum.

What causes a varicocele in child?

The veins in the scrotum may have valve problems or missing valves. Teen boys grow so quickly that the testicles need more blood than normal. If the veins have even small problems, they may not be able to move the extra blood quickly enough.

Other problems in groin anatomy may also increase the pressure inside the veins and cause swelling. In rare cases, swollen lymph nodes can block blood flow in the veins of the scrotum and cause pain.

What are the symptoms of a varicocele in a child?

Most boys with a varicocele don't have any symptoms. When they do occur, symptoms can include:

• Heavy feeling in the testicles that gets worse during or after exercise

• Ongoing dull ache in the scrotum

• One testicle that is smaller than the other

• Swollen blood vessels that can be felt in the scrotum

The symptoms of a varicocele can seem like other health conditions. Make sure your child sees his healthcare provider for a diagnosis.

How is a varicocele diagnosed in a child?

The healthcare provider will ask about your child’s symptoms and health history. They will give your child a physical exam. The physical exam will include checking the scrotum. Your child may also have an ultrasound. This is a painless imaging test that uses sound waves to make images of tissues in the body.

How is a varicocele treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how bad the condition is.

Treatment may be done to ease discomfort or pain. These include:

• Lying flat. Lying down flat on the back helps the blood flow in the right direction and drain from the scrotum.

• Underwear that supports the scrotum. This may be an athletic supporter or underwear briefs.

• Pain medicine. Over-the-counter medicines, such as ibuprofen or acetaminophen, can help lessen discomfort.

Varicoceles in teens don't often need treatment, unless the testicle has become much smaller or your child has a lot of pain. Treatment may include surgery or another method to take out or block the vein with the varicocele. The healthcare provider may suggest surgery if the testicles are very different in size. Surgery in a teen can restore correct blood flow in the scrotum. It can also help preserve the ability to have children (fertility) later.

Talk with your child’s healthcare providers about the risks, benefits, and possible side effects of all treatments. In an age-appropriate manner, include your child in these discussions. Be certain all of your child's questions are answered.

What are possible complications of a varicocele in a child?

If untreated, a varicocele may affect the ability to have children (fertility) later. It can affect the ability of sperm to swim to an egg (reduced sperm motility).

When should I call my child’s healthcare provider?

Call the healthcare provider if your child has:

• Symptoms that don’t get better, or get worse

• New symptoms

Key points about varicoceles in children

• A varicocele is when veins in the scrotum have become large and swollen (dilated).

• In most cases, there are no symptoms. When symptoms do occur, they can include a heavy feeling in the testicles, a dull ache in the scrotum, or one testicle that is smaller than the other.

• Treatment is needed if the testicle has become much smaller or your child has a lot of pain. Treatment may include surgery or another method to take out or block the vein with the varicocele.

• Your child can ease pain by lying flat, wearing supportive underwear, and taking pain medicine.

• If not treated, it may affect the ability to have children (fertility) later.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s healthcare provider after office hours. This is important if your child becomes ill and you have questions or need advice, especially after office hours or on weekends.