{"id":2504,"date":"2021-03-05T08:00:00","date_gmt":"2021-03-05T01:00:00","guid":{"rendered":"https:\/\/drsoaraweeurology.com\/?p=2504"},"modified":"2026-08-27T00:45:46","modified_gmt":"2026-08-26T17:45:46","slug":"varicocele-varicose-vein-testicle","status":"publish","type":"post","link":"https:\/\/drsoaraweeurology.com\/bn\/2021\/03\/05\/varicocele-varicose-vein-testicle\/","title":{"rendered":"\u09ad\u09cd\u09af\u09be\u09b0\u09bf\u0995\u09cb\u09b8\u09c7\u09b2: \u098f\u099f\u09bf \u0995\u09c0, \u0995\u0996\u09a8 \u098f\u099f\u09bf \u0997\u09c1\u09b0\u09c1\u09a4\u09cd\u09ac\u09aa\u09c2\u09b0\u09cd\u09a3, \u098f\u09ac\u0982 \u0995\u0996\u09a8 \u098f\u099f\u09bf\u0995\u09c7 \u0989\u09aa\u09c7\u0995\u09cd\u09b7\u09be \u0995\u09b0\u09be \u0989\u099a\u09bf\u09a4"},"content":{"rendered":"\n<div class=\"wp-block-columns coblocks-author-columns has-background is-layout-flex wp-container-core-columns-is-layout-52275889 wp-block-columns-is-layout-flex\" style=\"background-color:#8C8C971A;padding-top:2.5rem;padding-right:2.5rem;padding-bottom:2.5rem;padding-left:2.5rem\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:25%\">\n<figure class=\"wp-block-image size-full is-style-rounded\"><img data-recalc-dims=\"1\" fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"800\" data-attachment-id=\"7037\" data-permalink=\"https:\/\/drsoaraweeurology.com\/bn\/new-photo-2024\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" data-orig-size=\"800,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=800%2C800&#038;ssl=1\" alt=\"Best Urologist working in Chonburi and Cambodia\" 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rel=\"noopener\"\n     title=\"ORCID iD\"\n     aria-label=\"View ORCID Profile\"\n     style=\"text-decoration: none; color: #A6CE39; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M12 0C5.372 0 0 5.372 0 12s5.372 12 12 12 12-5.372 12-12S18.628 0 12 0zM7.369 4.378c.525 0 .947.431.947.947 0 .525-.422.947-.947.947-.525 0-.946-.422-.946-.947 0-.525.421-.947.946-.947zm-.722 3.038h1.444v10.041H6.647V7.416zm3.562 0h3.9c3.712 0 5.344 2.653 5.344 5.025 0 2.578-2.016 5.025-5.325 5.025h-3.919V7.416zm1.444 1.303v7.444h2.297c3.272 0 4.022-2.484 4.022-3.722 0-2.016-1.284-3.722-4.097-3.722h-2.222z\"\/>\n    <\/svg>\n  <\/a>\n  \n  <a href=\"https:\/\/scholar.google.com\/citations?user=lTgsRMUAAAAJ&#038;hl=en\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"Google Scholar\"\n     aria-label=\"View Google Scholar Profile\"\n     style=\"text-decoration: none; color: #4285F4; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M5.242 13.769L0.5 9.5 12 1l11.5 8.5-4.742 4.269C17.548 11.249 14.978 9.5 12 9.5c-2.977 0-5.548 1.748-6.758 4.269zM12 10a7 7 0 1 0 0 14 7 7 0 0 0 0-14z\"\/>\n    <\/svg>\n  <\/a>\n  \n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">A varicocele is a collection of dilated veins around the testicle \u2014 varicose veins, in the same sense as those in the leg. It affects roughly 15 to 20% of men, causes nothing at all in most of them, and is found in a much higher proportion of men investigated for infertility.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Two things follow from that, and this article is mostly about holding both at once. It is <strong>the commonest correctable cause of male infertility<\/strong> \u2014 and it is also <strong>frequently found in men it is doing nothing to<\/strong>, which is why not every varicocele should be operated on.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Urology center Bangkok hospital Thailand\u00a0<a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" target=\"_blank\" rel=\"noreferrer noopener\">Booking online<\/a>\u00a0<a href=\"tel:02-310-3009\">02-310-3009<\/a>\u00a0<a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a><\/li>\n\n\n\n<li>Samitivej Sriracha hospital Chonburi&nbsp;<a href=\"tel:088-022-1445\">088-022-1445<\/a><\/li>\n<\/ul>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-7387b849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n\n<figure class=\"wp-block-image size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"1112\" data-attachment-id=\"2521\" data-permalink=\"https:\/\/drsoaraweeurology.com\/bn\/2021\/03\/05\/varicocele-varicose-vein-testicle\/normal-anatomy\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Normal-Anatomy.png?fit=800%2C1112&amp;ssl=1\" data-orig-size=\"800,1112\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Normal Anatomy of testicular venous plexus (Purple colour)\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Normal Anatomy of testicular venous plexus (Purple colour)&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Normal-Anatomy.png?fit=737%2C1024&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Normal-Anatomy.png?resize=800%2C1112&#038;ssl=1\" alt=\"Diagram of the normal pampiniform venous plexus draining the testicle\" class=\"wp-image-2521\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Normal-Anatomy.png?w=800&amp;ssl=1 800w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Normal-Anatomy.png?resize=216%2C300&amp;ssl=1 216w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Normal-Anatomy.png?resize=737%2C1024&amp;ssl=1 737w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Normal-Anatomy.png?resize=768%2C1068&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Normal-Anatomy.png?resize=9%2C12&amp;ssl=1 9w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Normal drainage of the testicular veins.<\/figcaption><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n\n<figure class=\"wp-block-image size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"1112\" data-attachment-id=\"2524\" data-permalink=\"https:\/\/drsoaraweeurology.com\/bn\/2021\/03\/05\/varicocele-varicose-vein-testicle\/varicocele\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Varicocele.png?fit=800%2C1112&amp;ssl=1\" data-orig-size=\"800,1112\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Varicocele (Enlarged testicular venous plexus)\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Varicocele (Enlarged testicular venous plexus) &lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Varicocele.png?fit=737%2C1024&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Varicocele.png?resize=800%2C1112&#038;ssl=1\" alt=\"Diagram of a varicocele showing abnormally dilated testicular veins\" class=\"wp-image-2524\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Varicocele.png?w=800&amp;ssl=1 800w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Varicocele.png?resize=216%2C300&amp;ssl=1 216w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Varicocele.png?resize=737%2C1024&amp;ssl=1 737w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Varicocele.png?resize=768%2C1068&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Varicocele.png?resize=9%2C12&amp;ssl=1 9w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">In a varicocele the veins are dilated and blood pools around the testicle.<\/figcaption><\/figure>\n<\/div>\n<\/div>\n\n\n\n<h2 class=\"wp-block-heading\">Why it is almost always on the left<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Two anatomical facts explain it. The left testicular vein joins the left renal vein at a right angle, a longer and less favourable route than on the right, where the vein drains obliquely straight into the main abdominal vein. And the small valves that should stop blood flowing backwards often fail, so blood pools.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>That asymmetry is worth remembering, because it makes a right-sided varicocele unusual \u2014 and an isolated new one on the right is a reason to look further.<\/strong> See the red flags below.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">How it presents<\/h2>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Found during a fertility investigation<\/strong>, in a man with no symptoms at all. This is the commonest route to diagnosis. Pooled blood raises the temperature around the testicle \u2014 which needs to run cooler than the rest of the body to make sperm \u2014 and exposes it to oxidative stress and pressure.<\/li>\n\n\n\n<li><strong>A dull ache or heaviness<\/strong>, typically worse at the end of a day spent standing, and relieved by lying down.<\/li>\n\n\n\n<li><strong>Felt or seen by the man himself<\/strong> \u2014 the classic description is a bag of worms above the testicle.<\/li>\n<\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">Grading is by examination rather than by scan: <strong>Grade I<\/strong> is felt only when bearing down, <strong>Grade II<\/strong> is felt without, and <strong>Grade III<\/strong> is visible through the skin. Ultrasound confirms it, measures the veins and the size of each testicle, and detects backward flow.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"2520\" data-permalink=\"https:\/\/drsoaraweeurology.com\/bn\/2021\/03\/05\/varicocele-varicose-vein-testicle\/doctor-discussing-with-couple-in-the-clinic\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Infertility.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;Doctor discussing with couple in the clinic.&quot;,&quot;created_timestamp&quot;:&quot;1528902581&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;Doctor discussing with couple in the clinic.&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Varicocele usually incidentally finds at infertility clinic\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Varicocele usually incidentally finds at infertility clinic&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Infertility.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Infertility.jpg?resize=800%2C533&#038;ssl=1\" alt=\"Couple at a fertility consultation, the setting in which most varicoceles are discovered\" class=\"wp-image-2520\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Infertility.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Infertility.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Infertility.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Infertility.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Infertility.jpg?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Most varicoceles are found during a fertility investigation in a man with no symptoms.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">When treatment is worth it \u2014 and when it is not<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The earlier version of this article gave two indications. The list below is fuller, and includes the situation most often missed as well as the one most often over-treated.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Reasons to treat<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>A varicocele you can feel, an abnormal semen analysis, and a couple trying to conceive.<\/strong> This is the main one, and the female partner&#8217;s assessment belongs in the decision \u2014 operating on the man while an untreated problem sits on the other side helps nobody.<\/li>\n\n\n\n<li><strong>Pain that is genuinely attributable to it<\/strong> and has not settled with simple measures.<\/li>\n\n\n\n<li><strong>An adolescent whose affected testicle is failing to grow.<\/strong> This was absent from the earlier version and matters, because a boy with a varicocele and a testicle measurably smaller than the other side is losing something that can be recovered if treated and may not be later. It is a reason for a urological opinion rather than watchful waiting, and it is why a varicocele found in a teenager should be measured rather than merely noted.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Reasons not to<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>A varicocele visible only on ultrasound and not felt on examination.<\/strong> Scans pick these up readily, and <strong>treating them is not supported<\/strong> \u2014 this is the commonest reason men are operated on unnecessarily. If a urologist cannot feel it, the scan finding alone is not a reason to operate.<\/li>\n\n\n\n<li><strong>A man with a normal semen analysis who is not trying to conceive and has no pain.<\/strong> A varicocele that is doing nothing does not need correcting because it exists.<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"2522\" data-permalink=\"https:\/\/drsoaraweeurology.com\/bn\/2021\/03\/05\/varicocele-varicose-vein-testicle\/can-of-sperm-and-a-red-heart-in-a-mans-hands\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Semen-analysis.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;3.5&quot;,&quot;credit&quot;:&quot;Alexandr Korchagin&quot;,&quot;camera&quot;:&quot;NIKON D750&quot;,&quot;caption&quot;:&quot;can of sperm and a red heart in a man&#039;s hands. The concept of love and donation&quot;,&quot;created_timestamp&quot;:&quot;1551526050&quot;,&quot;copyright&quot;:&quot;vk.com\/vichuga_photo +79206745628&quot;,&quot;focal_length&quot;:&quot;85&quot;,&quot;iso&quot;:&quot;320&quot;,&quot;shutter_speed&quot;:&quot;0.00625&quot;,&quot;title&quot;:&quot;can of sperm and a red heart in a man&#039;s hands&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Abnormal semen analysis is a key indication for varicocele correction surgery\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Abnormal semen analysis is a key indication for varicocele correction surgery&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Semen-analysis.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Semen-analysis.jpg?resize=800%2C533&#038;ssl=1\" alt=\"Semen analysis under the microscope, the test that determines whether a varicocele needs treating\" class=\"wp-image-2522\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Semen-analysis.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Semen-analysis.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Semen-analysis.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Semen-analysis.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Semen-analysis.jpg?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">The semen analysis, not the scan, is what decides whether a varicocele needs treating.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">How it is treated, and what to expect<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>No medication corrects a varicocele<\/strong> \u2014 the dilated veins remain dilated whatever is taken by mouth, and supplements marketed for it do nothing to them. A venoactive drug of the kind used for leg varicose veins may ease the <em>ache<\/em> in someone avoiding surgery, on weak evidence; that is relief of a symptom rather than treatment of the condition, and it is discussed under <a href=\"https:\/\/drsoaraweeurology.com\/2021\/11\/19\/varicocele-treatment\/\">can a varicocele be treated with tablets<\/a>.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Microsurgical varicocelectomy<\/strong>, through a small incision at the top of the scrotum using an operating microscope, is the approach with the lowest rates of recurrence and of the commonest complication.<\/li>\n\n\n\n<li><strong>Embolisation<\/strong>, blocking the vein through a catheter without an incision, is an alternative \u2014 particularly where a varicocele has come back after surgery.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Honest expectations matter more here than technique. <strong>Semen parameters improve in a good proportion of appropriately selected men, but improvement is not the same as pregnancy<\/strong>, and neither is guaranteed. A varicocele can recur even after a technically sound operation. The recognised complications are fluid collecting around the testicle, recurrence, and \u2014 rarely \u2014 injury to the artery supplying it.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Judge the result at <strong>three months at the earliest<\/strong>, since sperm take about that long to be produced and mature \u2014 a test done sooner is still reporting on the situation before surgery. See <a href=\"https:\/\/drsoaraweeurology.com\/2023\/02\/05\/sperm-test-semen-analysis\/\">how to read a semen analysis<\/a>, and <a href=\"https:\/\/drsoaraweeurology.com\/2023\/02\/19\/chances-pregnancy-rate\/\">what the monthly chance of conception actually is<\/a>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Findings that need attention rather than a routine appointment<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">In an emergency in Thailand, call <strong>1669<\/strong>.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>A varicocele on the right side only, or one that appears suddenly, or one that does not drain away when you lie down.<\/strong> Because of the anatomy described above, these patterns raise the possibility that something in the abdomen is pressing on the vein, including a kidney tumour. It needs imaging of the abdomen rather than reassurance, and it is the single most important thing on this page.<\/li>\n\n\n\n<li><strong>A firm lump within the testicle itself<\/strong>, as opposed to the soft veins above it. That is a different problem and needs assessing promptly.<\/li>\n\n\n\n<li><strong>Sudden severe testicular pain<\/strong> \u2014 an emergency the same day, and not a varicocele.<\/li>\n\n\n\n<li>One testicle becoming noticeably smaller than the other, particularly in a teenager.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Frequently Asked Questions About Varicocele<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">Does varicocele cause male infertility?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">It is the commonest correctable cause of male infertility, and it is found in a substantially higher proportion of men investigated for fertility than in the general population. Pooled blood raises scrotal temperature, which sperm production depends on being lower than body temperature, and exposes the testicle to oxidative stress and pressure. That said, many men with a varicocele are entirely fertile \u2014 its presence does not by itself explain a fertility problem.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">My ultrasound found a varicocele but the doctor could not feel it. Should it be operated on?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">No. Treating a varicocele detectable only on imaging is not supported, and it is the commonest reason men undergo this operation without benefit. Grading is done by examination; the scan confirms and measures rather than decides.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Mine is on the right side. Does that matter?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">It is worth mentioning specifically. Varicoceles are overwhelmingly left-sided for anatomical reasons, so an isolated right-sided varicocele \u2014 particularly one that has appeared suddenly or does not empty when you lie flat \u2014 warrants imaging of the abdomen to exclude something pressing on the vein.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Will surgery guarantee a pregnancy?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">No. Semen parameters improve in a good proportion of well-selected men \u2014 a palpable varicocele, an abnormal semen analysis, and a partner without a major fertility problem \u2014 but improved parameters are not the same as a pregnancy, and recurrence is possible. Allow at least three months before judging the result.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">My teenage son has been told he has a varicocele. What now?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Most need only monitoring, but the testicles should be measured rather than simply examined. If the affected side is failing to grow in step with the other, that is a reason for a urological opinion, since growth can often be recovered with treatment and may not be later.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Is there a tablet for it?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Not one that corrects it. No medication or supplement makes dilated veins go away, so the options for the varicocele itself are surgery, embolisation, or leaving it alone \u2014 and leaving it alone is the right answer for a great many men. A venoactive drug may ease the ache in someone avoiding surgery, on weak evidence, which is a different question and is covered under <a href=\"https:\/\/drsoaraweeurology.com\/2021\/11\/19\/varicocele-treatment\/\">can a varicocele be treated with tablets<\/a>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Arranging a consultation<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Dr. Soarawee Weerasopone sees male fertility and andrology patients at <a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\">Bangkok Hospital Headquarters<\/a> and at Samitivej Sriracha Hospital in Chonburi on <a href=\"tel:0880221445\">088-022-1445<\/a>. Bring any semen analysis reports with their dates, and any results your partner already has.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bangkok Hospital Telemedicine is available for patients who cannot attend in person, including international patients \u2014 arrange it in advance by email to the Urology department at <a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a>. Samitivej Sriracha is in-person only. Enquiries about cost are answered by the hospital, not by this website.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Disclaimer:<\/strong> This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters, and is intended for education only. It is not medical advice, diagnosis or a prescription for any individual, and no advice, diagnosis or prescription is given through personal messaging channels or social media. Dr. Soarawee operates no public social media account; any account offering private consultation in his name is fraudulent. In an emergency in Thailand, call <strong>1669<\/strong>.<\/p>\n\n\n\n<script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\",\n  \"@graph\": [\n    {\n      \"@type\": \"MedicalWebPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/03\/05\/varicocele-varicose-vein-testicle\/#webpage\",\n      \"url\": \"https:\/\/drsoaraweeurology.com\/2021\/03\/05\/varicocele-varicose-vein-testicle\/\",\n      \"name\": \"Varicocele: What It Is, When It Matters, and When to Leave It Alone\",\n      \"description\": \"Varicocele is the commonest correctable cause of male infertility but is also frequently asymptomatic and over-treated. Indications for repair, why subclinical varicocele is not operated on, and the significance of an isolated right-sided varicocele.\",\n      \"inLanguage\": \"en\",\n      \"datePublished\": \"2021-03-05\",\n      \"dateModified\": \"2026-08-26\",\n      \"isPartOf\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#website\" },\n      \"author\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"reviewedBy\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"publisher\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"about\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/03\/05\/varicocele-varicose-vein-testicle\/#varicocele\" },\n      \"audience\": { \"@type\": \"MedicalAudience\", \"audienceType\": \"Patient\" },\n      \"disambiguatingDescription\": \"Three additions were made to the earlier version. An isolated right-sided varicocele, one of sudden onset, or one that does not decompress in the supine position may indicate retroperitoneal pathology including renal tumour and warrants abdominal imaging; this was absent and is now the leading red flag. Adolescent varicocele with ipsilateral testicular growth arrest was absent from the indications for treatment and has been added. Subclinical varicocele detected on ultrasound but not palpable is explicitly identified as not an indication for repair, being the commonest reason for unnecessary surgery. Embolisation, the absence of any effective medical therapy, recognised complications and the three-month interval before repeat semen analysis have also been added.\"\n    },\n    {\n      \"@type\": \"MedicalCondition\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/03\/05\/varicocele-varicose-vein-testicle\/#varicocele\",\n      \"name\": \"Varicocele\",\n      \"description\": \"Abnormal dilatation of the pampiniform venous plexus, affecting approximately 15 to 20 percent of men and a substantially higher proportion of those investigated for infertility. Predominantly left-sided owing to the perpendicular drainage of the left testicular vein into the left renal vein and incompetence of the anti-reflux valves.\",\n      \"signOrSymptom\": \"Frequently asymptomatic. May cause scrotal heaviness or aching worse on standing, or be detected by the patient as a bag of worms above the testis. Graded clinically: Grade I palpable with Valsalva, Grade II palpable at rest, Grade III visible.\",\n      \"possibleComplication\": \"Impaired spermatogenesis through raised scrotal temperature, oxidative stress and venous pressure; ipsilateral testicular growth arrest in adolescents. An isolated right-sided, sudden-onset or non-decompressing varicocele may indicate retroperitoneal mass or renal tumour obstructing venous drainage.\",\n      \"possibleTreatment\": {\n        \"@type\": \"MedicalProcedure\",\n        \"name\": \"Microsurgical subinguinal varicocelectomy or percutaneous embolisation\",\n        \"howPerformed\": \"Ligation of the dilated internal spermatic veins under an operating microscope, or catheter-directed occlusion. Indicated for palpable varicocele with abnormal semen analysis in couples attempting conception, attributable pain, or adolescent testicular growth arrest. Subclinical varicocele identified only on ultrasound is not an indication. No pharmacological treatment is effective. Recognised complications include hydrocele, recurrence and rarely testicular artery injury; semen analysis is repeated no sooner than three months.\"\n      }\n    },\n    {\n      \"@type\": \"FAQPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/03\/05\/varicocele-varicose-vein-testicle\/#faq\",\n      \"isPartOf\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/03\/05\/varicocele-varicose-vein-testicle\/#webpage\" },\n      \"mainEntity\": [\n        {\n          \"@type\": \"Question\",\n          \"name\": \"Does varicocele cause male infertility?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"It is the commonest correctable cause of male infertility, impairing sperm production through raised scrotal temperature, oxidative stress and venous pressure. Many men with a varicocele are nonetheless entirely fertile, so its presence alone does not explain a fertility problem.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"My ultrasound found a varicocele but the doctor could not feel it. Should it be operated on?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"No. Treating a varicocele detectable only on imaging is not supported and is the commonest reason men undergo this operation without benefit. Grading is clinical; the scan confirms and measures rather than decides.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"My varicocele is on the right side. Does that matter?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Yes, mention it specifically. Varicoceles are overwhelmingly left-sided for anatomical reasons, so an isolated right-sided varicocele, particularly one of sudden onset or one that does not empty when lying flat, warrants abdominal imaging to exclude a mass pressing on the vein.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"My teenage son has a varicocele. What happens now?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Most require only monitoring, but the testicles should be measured rather than simply examined. If the affected side is failing to grow in step with the other, that is a reason for urological review, since growth can often be recovered with treatment and may not be later.\" }\n        }\n      ]\n    }\n  ]\n}\n<\/script>\n","protected":false},"excerpt":{"rendered":"<p>Common, usually silent, and frequently over-treated. What a varicocele does to fertility, which ones are worth operating on, why a scan-only finding is not an indication \u2014 and the one presentation that needs investigating urgently.<\/p>","protected":false},"author":185281453,"featured_media":10124,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"advanced_seo_description":"Varicocele affects up to a fifth of men and is the commonest correctable cause of male infertility. Which ones need treating, why ultrasound-only varicocele is not operated on, and the red flag.","jetpack_seo_html_title":"Varicocele: Fertility, Grading and When Surgery Helps | Dr. Soarawee","jetpack_seo_noindex":false,"jetpack_seo_schema_type":"","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_wpcom_ai_launchpad_first_post":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"{title}\n\n{excerpt}\n\n{url}","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"_wpas_customize_per_network":false,"jetpack_post_was_ever_published":false},"categories":[1363],"tags":[1414,1413],"class_list":["post-2504","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-mens-health","tag-scrotal-varicocele","tag-varicocele"],"jetpack_publicize_connections":[],"jetpack_likes_enabled":false,"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/pgZdrK-Eo","jetpack_featured_media_url":"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/04\/Varicocele.jpg?fit=1200%2C630&ssl=1","_links":{"self":[{"href":"https:\/\/drsoaraweeurology.com\/bn\/wp-json\/wp\/v2\/posts\/2504","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drsoaraweeurology.com\/bn\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drsoaraweeurology.com\/bn\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/bn\/wp-json\/wp\/v2\/users\/185281453"}],"replies":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/bn\/wp-json\/wp\/v2\/comments?post=2504"}],"version-history":[{"count":27,"href":"https:\/\/drsoaraweeurology.com\/bn\/wp-json\/wp\/v2\/posts\/2504\/revisions"}],"predecessor-version":[{"id":11739,"href":"https:\/\/drsoaraweeurology.com\/bn\/wp-json\/wp\/v2\/posts\/2504\/revisions\/11739"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/bn\/wp-json\/wp\/v2\/media\/10124"}],"wp:attachment":[{"href":"https:\/\/drsoaraweeurology.com\/bn\/wp-json\/wp\/v2\/media?parent=2504"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/bn\/wp-json\/wp\/v2\/categories?post=2504"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/bn\/wp-json\/wp\/v2\/tags?post=2504"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}