Most of you won't bother reading all of these, because:
A. There's a metric fuckton of them
B. Most of you don't have the ADHD hyperfocus/zerofocus that I have
C. No one reads anymore, (which is deeply frustrating and not a small part of why I have exactly zero chill these days) but here. Here's a trove of stuff I've read that has contributed in part to my knowledge of the condition.
DIS-FUCKING-CLAIMER:
-These should not all be taken as gospel
-Some studies have biases that are undocumented
-Some studies are just blatantly wrong. I've tried not including those, but I'm not perfect
-Some studies are ego-trips of doctors looking to score points against other doctors they don't like
-Some studies conflict with others, some even directly
-Science is ever-evolving, if we simply let it. Good research requires a non-political, free, if responsible and ethical hand
-Older studies (10+ years) should always been taken with an extra grain of salt, but that does NOT mean newer studies are more correct or should be less subject to scrutiny
-I've read nearly all of these at least once. In some cases, it's been a while, so quoting specific ones or asking me why one conflicts with another is likely to upset me because it means you didn't read what I said; literally directly above this, or you didn't fully process it, but I will say it again: NOT ALL STUDIES ARE MADE EQUAL. I dunno, ask the authors why things conflict.
-This is not an exhaustive list
-This is not an exhaustive list
-THIS IS NOT AN EXHAUSTIVE LIST
-If you want a study or paper added, DM it to me, don't comment on this post
-I do this for your benefit as much as anyone else's. I truly hope this leads to some good insights, maybe even some astoundingly good ones; who knows, I live in hope, and at the very least (not bloody likely) fewer questions sent to my inbox :D
Oh, and...you'll want to scroll. Left AND Right, Up AND Down.
A varicocele is an enlargement of the veins within the scrotum. These veins transport oxygen-depleted blood from the testicles. A varicocele occurs when blood pools in the veins rather than circulating efficiently out of the scrotum.
Left sided grade 3 varicocele
The left testis is affected much more commonly (≈85%) than the right. This may be due to the shorter course of the right testicular vein and its oblique insertion into the inferior vena cava (IVC) which creates less backpressure. In contrast, the left testicular vein has a longer course and inserts into the left renal vein at a right angle. Bilateral varicoceles are not uncommon (≈15%), but an isolated right varicocele is rarer.
Possible signs and symptoms may include :
A mass in the scrotum – If a varicocele is large enough, a mass like a “bag of worms” may be visible above the testicle. A smaller varicocele may be too small to see but noticeable by touch.
Pain – A dull, aching pain or discomfort is more likely when standing or late in the day. Lying down often relieves pain.
Significantly different sized testicles – The affected testicle may be noticeably smaller than the other testicle.
Infertility – A varicocele may lead to difficulty fathering a child, but not all varicoceles cause infertility. The main test to check for infertility is a semen analysis test.
Low/Lower testosterone levels - Generally, men with varicoceles have lower testosterone levels than men without varicoceles. Symptoms of low testosterone can include: low libido, erectile dysfunction, infrequent erections, low energy, fatigue, low mood and depression, decreased motivation and self-confidence, increased body fat and decreased muscle mass and strength, brain fog.
The only way to know for sure if you have low testosterone levels is to have your levels checked with a blood test. This can be easily done by going to your doctor.
Physical exam – A urologist or other doctor will visually inspect the scrotum for lumps or bumps, and feel for any swelling or tenderness. The exam may be performed while the patient is standing to relax the scrotum.
Imaging test – Your health care provider may want you to have an ultrasound exam. Ultrasound uses high-frequency sound waves to create images of structures inside your body.
These images may be used to:
Confirm the diagnosis or characterize the varicocele.
Eliminate another condition as a possible cause of signs or symptoms
Detect a lesion or other factor obstructing blood flow
Typical image of a varicocele found on an ultrasound scan
A varicocele is usually diagnosed when a vein around or above the testicle is at least 3 millimetres in diameter. However, there is no consensus on the exact threshold value for defining a varicocele.
Grading
Varicoceles are graded based on their size and visibility:
Grade I: Can only be felt when straining (Valsalva manoeuvre)
Grade II: Can be felt when standing, but not visible
Grade III: Clearly visible during an exam
All sizes of varicocele can cause symptoms and are likely to affect testicular function. Higher grade varicoceles are thought to affect testicular function more.
Why varicoceles occur
Varicose veins develop when the valves in veins are damaged or weakened, causing blood to pool and flow backward.
Unfortunately, once your vein valves are damaged, they cannot completely heal on their own. Once a vein valve is damaged or weakened, it loses its ability to properly regulate the flow of blood.
Arrow showing direction of blood reflux. In this image, due to damaged valves in the left gonadal vein, instead of blood correctly draining from the left testicle into the left renal vein, blood is pooling in the scrotum and causing a left sided varicocele. The right gonadal vein is functioning correctly.Left- Vein valves working properly. Right - Vein valves have failed and are now not functioning correctly. Blood is not travelling through the vein correctly.
Treatment options
Varicoceles cannot be cured naturally without medical intervention.
The success rate for varicocele procedures is high, with both varicocele embolization and varicocelectomy procedures having success rates of over 90%.
Treatment options include:
Embolization
Microscopic varicocelectomy(microsurgery)
Inguinal or subinguinal. With or Without delivery.
Hola a todos, quiero hacerme una cirugía con el doctor Mario mejia de CDMX o con doctor Daniel Carrillo que hace también la técnica de stambul en CDMX, alguien que se la haya hecho que me dé opiniones.
Todos los urólogos. Alos que fui me han dicho lo mismo, me operan hasta donde soporte el dolor.
Estoy contento porque ya me había hecho una cirugía bilateral hace 8 años, nunca se fue el dolor.
Ver Parte I a la IV en mi perfil y sigueme para entender mi historial
Marzo 2026, me opere. La recuperación es dolorosa al inicio pero vale la pena. Debes tener muchos cuidados. Desde Abril comencé a tomar suplementos de mejora de la calidad de esperma y 6 meses despues me hice un examen, que va mostrando mejoras:
Conteo Total: 102Millones
Movilidad: 26%
Morfología: 3%
Vitalidad: 31%
Estoy trabajando para obtener la mejora espermática, no tengo conocimiento desde cuando padecía del varicocele, así que no se que tan dañado puede estar mis testiculos.
A long time ago probably like 5 years I don’t really remember, I got open surgery for a massive left sided varicocele after a first failed surgery (I think it was micro or laparoscopic?, small incision above my groin sorta thing) it was causing me a lot of pain and was a really traumatic experience. The open surgery did work tho and the mass and pain went away and I was able to move on with my life. About a month ago I noticed the veiny growth starting to reform on the left side but I pushed in aside hoping it was just scarring or something but as time went by I started getting that gradual familiar pain, this time on the right side as well and sure enough it would seem it has come back on both sides this time. Super depressing I am wondering if recently starting to lift weights and do a lot of squats and stuff ect could have been the catalyst to the reappearance? Going to see a urologist soon I have only just got the ultrasounds booked in. Super duper depressed and worried it could have come back from an underlying more difficult to treat issue. The pain onset has been super rapid. Just wondering if anyone has had any similar experiences and if lifting weights has any correlation?
Sperm DNA Fragmentation Index (DFI): 27% (SCSA method)
High DNA Stainability (HDS): 5%
FSH: 2.37
LH: 3.55
Prolactin: 17.11
Grade 1 varicocele right side
Right epididymal head measures 0.8x0.7cm and appears normal in size with regular contours and homogenous echogenicity with a cyst measuring 2x1.9mm noted within
Grade 3 varicocele left side
E/o multiple dilated venous channels measuring approx. 2.5 to 2.8mm, 2.7 to 2.9mm and 2.7 to 3.0mm in the cord, lateral and basal aspects of left testis and showing reflux on Valsalva.
Initially I was thinking of going for micro surgery varicocele but my family insisting on going for IVF/ICSI directly (my wife is ready). I read somewhere like urologists are recommending this to make money and in somecases i heard like the parameters did not improve post surgery.
I am confused now what should I do now ? If you gone through the same situation what you did and why ? Please share your experiences.
Heyy i(17m) had the varicocele surgery back in February and it was a grade 4 i think like it was like alot of veins it looked like 2 or 3 worms were in there😭 and i got surgery and not all of the veins were gone when i had the ultrasound again it said a remaining grade 1 and is it normal and btw my area right beneath the incision is still numb like bro when is it gona be normal again and i still some sudden painful moments still now is everything gud ?
26M here
Noticed some bag of worms-like on my testis
Went to my GP he confirmed Vericocele, just said I manage it
I got curious and had to do Scrotal ultra sound because I noticed my balls we’re kinda small, result came out and there are 10cm vol and 9.5cm vol respectively, went back to show my GP to consult if I need a surgery for the Vericocele, he said since no pain it’s pointless and that the ball size can just manage or give me pills to increase lil growth.
I’m confused on what to do now, I’m new in this country and his the only one I’ve been consulting for all medical concerns, anyone think I should look for other urologist? But how to know. Good one since I’m new in this country, any suggestions pls thanks
Hello everyone! What was your timeline for treatment like? I am being told 4-8 weeks for a consultation, and another 4-8 weeks to schedule surgery. Is this typical? A few doctors can see me sooner, but is it worth waiting?
Hey guys, I need some advice back in in February I had varicoceleectomy surgery and had immediate pain in my left testicle from it which I didn’t have before. Suffered for months it never really got any better than I went and saw another urologist did multiple test and ultimately he thought that it may be a spermatic cord nerve issue so I got the nerve block and the nerve block worked for a couple hours. Scheduled surgery and I had surgery about two weeks ago. Well now I still have the same pain in my left testicle and the pain has completely moved. It was on the rear of my testicle. Now it’s on the top side of my testicle.anyone else have any advice my mental state is destroyed.
Buongiorno ho 25 anni e due anni fa sono stato operato al varicocele sinistro di 4° grado con embolizzazione,sono stato benino fino a poco tempo fa che ho accusato di nuovo i sintomi da varicocele e ho scoperto di avere una recidiva. Qualcuno di voi ha avuto la stessa esperienza ? Se si cosa mi consigliate di fare ? In più ho anche un fastidio che si irradia nella gamba sinistra fino al piede(stessa sensazione del testicolo). Sono disperato perché ha ridotto di molto la mia qualità di vita. Dovrei fare la chirurgia sta volta o una seconda embolizzazione? Grazie in anticipo!
Im 24 M I had Subinguinal microsurgical varicocelectomy 2 months ago i had grade 3 in my left and grade 2 in my right. The pain is normal before surgery the pain was unbearable but now its less but is it still normal for veins to get dilated after surgery. Also the vein on my penis gets big not very big but its visible. Anyone else had this type of experience?
A bit of backstory, I have had a varicocele on my left testicle since my early teens. It has got bigger over the years but hasn’t ever caused me any pain. However, over the past few years I have had difficulties with low libido (very low virtually no interest or urge to have sex) , poor sleep and more recently I have gained a little bit of weight and struggle to get in shape no matter how I eat or workout. I am slightly overweight but consider myself fairly active and energetic, despite the other issues. I’m 30 Y/o 5’11 and 200 lbs . But I don’t see the results I’d expect from my lifestyle.
I was referred to a Urologist for a testicular cyst on the right side, for which I had surgery carried out. The urologist also identified the varicocele on the left side but advised me not to have surgery on this as “it doesnt have any effect on sperm production or testosterone levels” I have since found out that is not the case and that a Varicocele can have a significant impact on both of these things.
So I have started to connect the dots and wonder if the varicocele is causing my issues. I had my testosterone level checked this week which came back as 14.4 Nmol (414 ngdl). Which isn’t classed as low but is on the borderline.
I am considering going back to the Urologist and requesting treatment. I’d just like to know if anyone else had similar levels and symptoms to me prior to surgery and if surgery resulted in a noticeable improvement ?
Hi everyone,
I'm 18 years old and I've been dealing with testicular and sexual problems for almost two years. I'm looking for experiences from people who have gone through something similar, especially after varicocele embolization, because despite multiple medical examinations and consultations, I still don't have clear answers. March 2024: I started experiencing pain in my left testicle for about a month. The pain eventually disappeared, but the veins around my testicle remained much larger than before. September 2024: I started experiencing erectile dysfunction, a significant decrease in libido, and a lower semen volume. These symptoms gradually got worse. July 2025: I underwent embolization for a left-sided varicocele. A few days after the procedure, I started smoking again and didn't really rest properly, and I subsequently experienced significant pain. In August, imaging showed that the varicocele was no longer visible. I temporarily started getting morning erections again, and my libido, erections and semen volume improved somewhat. However, the veins were still visible. Late 2025: My symptoms started fluctuating. I sometimes experienced improvements in libido and erections, followed by major relapses, particularly after drinking alcohol or smoking. Even when I stopped these habits, improved my diet, slept 7–10 hours a night and walked more than 10,000 steps a day, the symptoms kept coming back. Early 2026: Despite several testicular and abdominal scans that showed no varicocele, my symptoms continued. I went through periods of several months with practically no spontaneous erections, almost no libido, very low semen volume, and sometimes burning sensations radiating toward my upper thighs and lower abdomen. I also experienced periods of significant fatigue and changes in sleep and motivation.
In July 2026, for several weeks, I was producing almost no visible semen when ejaculating, mainly a clear fluid, sometimes accompanied by pain above my penis and in my lower abdomen. September 2026: A CT scan eventually confirmed that the varicocele had recurred on both sides.
What worries me most now is the apparent reduction in the size of one of my testicles. It looks incredibly small, sometimes almost smaller than a grape. I haven't had its exact volume measured yet, so I can't confirm the extent of the shrinkage, but the visual difference is very significant. My testicles also often feel cold.
Regarding my blood tests, my total testosterone was around 15.8–16.1 nmol/L, with FSH at 2.2, LH at 5.1 and prolactin at 19.9, which was flagged as slightly elevated. My urologist told me there was no significant hormonal imbalance. However, my sexual problems persist. I haven't had a recent semen analysis, so I don't know the current state of my fertility.
I should also mention that I used drugs a lot start a 15 , including cannabis and other substances, but I stopped around a year ago. I have also smoked tobacco and consumed alcohol. I lift weights and sometimes train with heavy loads. I've wondered whether any of these factors could have contributed, although my symptoms began around the time my varicocele first appeared. I don't want to jump to conclusions without evidence.
I also tried tadalafil 5 mg once, without any obvious effect initially. After another dose, I noticed that erections became easier to achieve.
At this point, I'm even starting to wonder whether there could be another underlying problem besides the varicocele, especially because my symptoms continued even when imaging showed no visible varicocele. I don't understand how I can have so many problems at 18 when my hormone tests are considered reassuring.
I'm still under medical care, but appointments and investigations take a long time. Given
It feels like I lost sensitivity nothing I do works and I am panicking.
I was hit in my testicles very strong , I was immediately sent to the ER at a hospital , they performed an ultrasound and supposedly the results came back”normal” now almost a week of the incident the pain is gone but can’t get erect nothing nothing works. WTF do I do now
23 M. I noticed this strange thing on my left testicle. When I'm standing up it goes back to normal, but when I lie down at a certain angle it appears. I feel zero pain or discomfort. If relevant, I also had a fungal infection on my scrotum recently. Thank you for your help.
34 male - 8 days post left varicocele embolisation. Is it normal to have quite intense pain in the testicle and sharp shooting/spasmy pain going from testicle through veins up to groin/lower abdomen? Pain is quite intense and is same pain as before surgery. Is this normal? Thanks
Hi, 21M. About 5 years ago I had varicocele surgery on my left side, done without a microscope. Five years later it came back, this time on both sides. My ultrasound, blood tests, and semen analysis were really bad, so my doctor recommended a bilateral redo with microsurgery, which I had 3.5 months ago.
Since then my semen analysis has improved significantly, and I’ve had several ultrasounds whenever I felt discomfort, all showing zero reflux. But the symptoms haven’t gone away: lumpiness, heaviness, and a pulling feeling, especially after sex or the gym. My veins are still 4.8 mm, which worries me.
The discomfort is really wearing on me. When it flares up, it distracts me, keeps me anxious, and basically puts my life on pause.
My doctor says it takes time for the blood to re-route, but I’d love to hear from anyone who’s been through this. Did it eventually go away for you? Are the wider veins what’s causing the heaviness and puffiness? And if my veins never shrink, does that mean it’ll feel like this forever?
