VaricoceleVaricocele: enlarged veins in the scrotum.A varicocele is a swelling of the veins above a testicle, similar to varicose veins in the leg. It is common and usually causes no symptoms, and most men and boys who have one do not need treatment. Any new swelling is still worth having checked.Book a GP appointmentCall 07857 761328Sudden pain in a testicle or the scrotum can be an emergency. Call 999 or go to A&E straight away.Same & next-day appointmentsPrivate, careful examinationReferral if you need itYou keep your NHS GPPrivate exam £1201What is it?2Signs3Sizes4Fertility5Your appointment6Treatment7How to help8Get help now9FAQs Medically reviewed by Dr Sam R Bandularatne, MBBS, DFMS, MRCGP · GP Partner & GP Trainer · GMC 5208303OUR GP Dundee · Last reviewed November 2026Seen by a GPOther causes ruled outTests when they are neededClear plan and referral if neededStart hereWhat a varicocele isThe veins that carry blood away from the testicle become wider and twisted.Varicoceles affect about 15 to 20 in every 100 men and teenage boys, and usually become noticeable around puberty, when the testicles grow and blood flow to them increases. About 9 in 10 are on the left side only, and about 1 in 10 affect both sides.The exact cause is not fully understood. The valves in the veins and the pressure inside them are thought to play a part, and genes may too. The vein on the left is longer and joins a larger vein at a right angle, which helps explain why the left side is affected so much more often.It is commonMany men have one and never know, because most varicoceles cause no symptoms.It is usually on the leftThat is because of the way the veins on each side drain.It starts around pubertyVaricoceles tend to appear as the body and testicles grow.Most need no treatmentIf yours does not need treating, it is unlikely to cause long-term problems.Back to top ↑Signs to look forWhat you might noticeOften nothing at all. A varicocele may only be found by chance during an examination or a scan.A painless swelling above the testicle, often said to feel like a ‘bag of worms’One side of the scrotum, usually the left, hanging lower than the otherSwelling that is more obvious when you stand, and usually goes down when you lie downA smaller testicle on that side, mainly in teenage boys with a larger varicoceleA dragging or heavy feeling in the scrotumAn ache in the scrotum or groinPain is uncommon. Fewer than 3 in 100 men with a varicocele have pain or a dragging, heavy feeling. Sudden pain is different and needs urgent help: see when it can’t wait.At OUR GPA private examination for a varicoceleFor men with a lump, ache or heavy feeling in the scrotum, or concerns about fertility.A 30-minute face-to-face appointment with an examination and a scan or referral if needed.Good to know: a new lump in the scrotum should always be checked, even if it does not hurt.About GP appointments →£12030 minutes face to face · video £110 · phone £60 Book nowBack to top ↑SizesHow varicoceles are gradedDoctors grade a varicocele by how easily it can be felt or seen.SizeWhat it meansVery small (subclinical)Cannot be felt. It only shows up on an ultrasound scan.Small (grade 1)Can only be felt when you hold your breath and bear down.Moderate (grade 2)Can be felt without bearing down, but cannot be seen.Large (grade 3)Big enough to be seen through the skin of the scrotum, without needing to feel for it.Who is more likely to have oneAnyone with testicles can develop a varicocele, but it is more likely if you:are tall and leanare underweighthave a close relative with a varicoceleBack to top ↑Fertility and growthFertility and testicle growthNearly two in three men with a varicocele have no difficulty fathering children.In adultsA varicocele can be linked with lower sperm quality and fertility problems. If fertility is a concern, a semen test and hormone blood tests can help to show how the testicles are working.In teenage boysA larger varicocele can slow the growth of the testicle. If the testicles are the same size, a check each year through puberty is usually what is needed.Back to top ↑Your appointmentWhat the GP will doThe diagnosis can usually be made from an examination.Listen and examineWe ask about your symptoms and examine you lying down and standing up. This is often all that is needed.Arrange an ultrasound if neededA scan can help if we are unsure what the swelling is, or if the area is hard to examine.Offer tests if fertility is a concernSuch as a semen test and hormone blood tests.Plan what happens nextThis may be reassurance, a check-up later on, or a referral to a urologist. Teenage boys may have a yearly check through puberty.Back to top ↑TreatmentWill I need treatment?Usually not. We may refer you to a urologist if your varicocele is causing pain, if it may be affecting your fertility, or if a teenage boy’s testicle is smaller or not growing as it should.The urologist will explain the risks and benefits of the options:An operationA surgeon closes off the enlarged veins so that blood takes another route.EmbolisationThe veins are blocked from inside, using a fine tube guided by x-ray, without an operation.What treatment can do. It can reduce pain and improve testicle size and semen quality. It is less clear whether it leads to more pregnancies, so it is not routinely offered for fertility alone.Back to top ↑How to helpHow you can help yourselfIf your varicocele does not need treating, a few simple things can help with any discomfort.Supportive underwearCan ease a dragging or heavy feeling in the scrotum.Simple pain reliefPainkillers can ease an ache. Follow the directions on the pack.Talk to usTell us if you are worried about fertility or about how it looks.Parents and teenagersBook a check if a boy or his parents are worried about how it looks or feels. VaricoceleDownload our varicocele leafletA free two-page guide: what a varicocele is, what you might notice, what the doctor will do, the treatment options and when to get help.PDF · 2 pages · A4 · 530 KBDownload leaflet (PDF)Open to printBack to top ↑Get help nowWhen it can’t waitCall 999 or go to A&E straight away ifyou have sudden pain in the scrotum or a testicle, with or without swelling, as this may be a twisted testicle · you have severe scrotal pain with a fever, or feel very unwell · you have pain and swelling after an injuryContact a GP the same day, or NHS 24 on 111 out of hours, ifa swelling appears suddenly, without pain, or the swelling stays tense or does not go down when you lie down.Book an appointment soon for a painless lump or a change in a testicle, an ache that keeps coming back, or if a boy or his parents are worried.A private appointment is not a substitute for emergency care. If you are unsure, call 999 or NHS 24 on 111.Back to top ↑FAQsCommon questions Is a varicocele dangerous?Most varicoceles cause no symptoms, do not affect fertility and never need treatment. If yours does not need treating, it is unlikely to cause symptoms or long-term problems. Any new swelling is still worth having checked, because other conditions can look similar. Will a varicocele stop me having children?Usually not. Nearly two in three men with a varicocele have no difficulty fathering children, although it can be linked with fertility problems. If you are worried, a GP can talk through tests such as a semen test. Why is it usually on the left?The left vein is longer and joins a larger vein at a right angle, which raises the pressure inside it. About 9 in 10 varicoceles are on the left only, and about 1 in 10 affect both sides. Do I need an operation?Most people do not. A urologist may discuss an operation or embolisation if a varicocele is causing pain, may be affecting your fertility, or a teenage boy’s testicle is smaller or not growing as it should. Should my teenage son be seen?Yes, if you have noticed a swelling or he is worried. Larger varicoceles can slow the growth of the testicle, so a GP will examine him and may suggest a yearly check through puberty. How can I ease the discomfort?Supportive underwear and simple painkillers are the usual first steps. If it keeps aching, book a routine appointment.Worried right now?Sudden pain in a testicle or the scrotum can be an emergency. Call 999 or go to A&E. Out of hours for anything less urgent, call NHS 24 on 111.Back to top ↑EvidenceWhere this information comes fromThis page follows UK clinical guidance on recognising and managing varicocele.NICE CKS: VaricoceleNICE CKS: Scrotal pain and swellingBMJ Best Practice: VaricoceleCambridge University Hospitals NHS: Having a varicocele embolisationBack to top ↑Worried about a swelling in the scrotum?Book a GP appointment for a careful, private check and a clear plan.Book a GP appointmentWhatsApp 07857 761328This page is general information and is not medical advice or a diagnosis. What’s appropriate is a clinical decision made with a GP at your appointment. OUR GP is a trading name of SRS Health Group Limited, regulated by Healthcare Improvement Scotland. All doctors hold a licence to practise with the General Medical Council. Meet our team. We see patients from Dundee, Angus, Perthshire and Fife. More questions? See our FAQs.