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A Vericocele is a medical condition characterized by an enlargement of the veins within the scrotum that holds the testicles. It seems similar to the varicose veins which often occur in the legs. Most varicocele develops over time and are more common in the adult male population aged between 15-25 years. This abnormality in vein generally form during puberty and often seen in the left side of testicles because of the difference in anatomical positioning of the scrotum. However,varicocele can exist on both the sides but it is very rare.

Vericocele is the most common cause of depleted sperm quality and low sperm production which eventually results in infertility problems in males. This may also cause testicles to fail to develop normally or to shrink. Though not all varicocele affects sperm production, it is assumed that if one side of testicles is damaged then the sperm production on both the testicles is affected.

Vericocele might cause

  • Infertility : Due to varicocele, the local temperature in and around the testicles becomes very high which affects the movement, production and functioning of the sperms adversely. This is the main reason why adult males suffering from Vericocele often faces infertility issues.
  • Atrophy of the testicles : Normally testicles comprises of the sperm producing tubules. But if damaged by varicocele the testicles tend to shrink and soften.

Causes and Symptoms

The exact cause of varicocele is still unclear. Also there are no known established risk factors for developing a varicocele. The testicles are hold by a spermatic cord. This cord comprises of arteries, veins and nerves that supports this gland. In a healthy vein which is inside the scrotum the blood circulation in the testicles to scrotum is moved by the one-way valve and then return back to the heart. On the other hand if the blood circulation from the vein is not proper then it gets collected in the veins causing it to enlarge gradually and develops as a vericocele.

Vericocele usually produces no signs and symptoms. With time it may get enlarge and becomes noticeable. Apart from this following are the significant symptoms which indicate the development of Vericocele.

  • Sharp to dull, pain and discomfort
  • Increased pain with standing for longer period
  • Increased pain with physical exhaustion
  • Pain that gets worsens over the course of day.
  • Impaired fertility


Following are the surgical interventions performed for Vericocele :

  • Varicocelectomy is the surgical procedure during which the patient is given Local anaesthesia and mild sedative. The urologist performs the surgery through your abdomen or groin and clamps the abnormal veins allowing the blood to flow in the right direction and diverted from the abnormal veins. Blood can then flow around the abnormal veins to the normal ones.
  • Vericocele Embolization is not a surgery it is a minimally invasive procedure performed by a vascular specialist. This procedure helps in cutting off or closing the blood flow to the damaged veins which causes the shrinking of the varicocele. A small catheter is inserted into a groin. A coil is then placed into the catheter and into the varicocele. This breaks the link of blood flow to the abnormal veins and the varicocele shrinks and dies.


  • Vericocelectomy/Surgical ligation : This procedure is performed by a urologist using either open or laparoscopic surgical method. The surgeon will make incision on the abdomen, the incision runs from above the scrotum continuing down the testicular veins. The laparoscopic instruments are then passed through this incision to see and repair the vericocele. These incisions are then sutured off and the patient can leave after an overnight stay at the hospital. This entire procedure is done under general anaesthesia.
  • Varicocele embolization or catheter-directed embolization : This is now a commonly used technique performed by an interventional radiologist. It is a non-surgical method of treatment. The patient is anesthetized locally and a catheter is introduced into the femoral vein and into the testicular vein directly. A contrast medium is injected for visualizing and imaging the embolization of the vein. Coils called sclerosants block the abnormal vein and decrease the pressure on varicocele. Therefore the blood flow to the abnormal vein is cut off and redirected to other pathways. The procedure usually takes 2 hours to complete.


If you have the below mentioned symptoms you can be a candidate for surgery or embolization for varicocele

  • When the varicocele is palpable
  • Testicular pain
  • Infertility
  • Discomfort
  • Testicular atrophy
  • Abnormal sperms
  • Swelling in Scrotum


The recovery time for embolization is quicker and less as compared to surgery. The pain caused is also very less. The patient can get back to his work in a weeks time after embolization. If surgical ligation is done then it may take 2-6 days for complete recovery dependingon the type of technique that is open surgery or laparoscopic surgery.


The results with both procedures are best with firmness of the problem; however the chances of recurrence with embolization are possible rather than with surgical approach. The effect of the procedures is not yet clear on the fertility part, but it does improve the quality of the sperm.

Estimated Cost

SNo Name of Procedure Cost in India (USD)
1 Varicocelectomy Surgery 2500 - 3500
2 Varicocele Embolisation 3000 - 4000

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