They are mostly painless but can sometimes cause dull aching pain in the testicles. If it is big enough, the swelling may be prominent and make the testicles appear to be of varied sizes. There may be difficulty in performing activities like cycling, riding a bike, or even being on feet for too long. However, the biggest concern in varicocele is suffering from male infertility or difficulty in fathering a child.

The diagnosis is by physical examination and after listening to a patient’s symptoms. However, an ultrasound is imperative to confirm the diagnosis. You may also be asked to do a semen analysis to check if fertility is affected.

Grading of Varicocele determines the treatment hence ultrasound plays a major role here. For grade 1 and 2 which are the earliest grades conservative or symptomatic treatment is suggested, however for grade 3 and 4 surgery is recommended where the enlarged portion of the vein or extra portion of the vein is removed surgically. This also can be done using laparoscopy or a minimally invasive approach.