Varicocele

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Diagnosis

Large varicoceles may be seen with the naked eye. Medium-sized varicoceles may be detected during physical examination by feeling (palpating) the area. A patient suspected of having a varicocele should be examined while standing up, as a varicocele is more prominent in this position than while lying down, face up (supine).

Small varicoceles may be discovered by a physician using one of the following procedures.

• Doppler ultrasonography uses ultrasound echos to detect the characteristic sound of the backflow of blood through the valve.
• Thermography uses infrared sensing technology to detect pockets of heat caused by pooled blood.
• Venogram is an outpatient procedure performed under local anesthesia. The physician makes a small puncture in the groin and then injects a special dye into the spermatic vein. The dye in the bloodstream enables the physician to see the anatomy in the vein on x-ray and detect the presence of a very small varicocele.

If the patient is being examined for suspected infertility, the physician usually performs a comparison of semen samples. Infertility caused by a varicocele typically produces a consistent pattern of low sperm count, poor sperm motility (movement), and abnormal sperm morphology (e.g., immature, incompletely developed, damaged, dead, or dying sperm).

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