Groin and genital area
Varicocele in boys
A dilation of the veins of the testicle caused by venous blood reflux within the internal spermatic cord.
Varicocele
A varicocele is a dilation of the veins of the testicle caused by venous blood reflux within the internal spermatic cord.
It is a condition that may appear during adolescence and most often affects the left side. In some cases, it may cause symptoms; in others, it is discovered during a routine check-up.
The presence of a varicocele alone does not automatically mean that surgery is needed: the decision depends on symptoms, testicular growth and specialist assessment.
Symptoms and signs to look out for
A varicocele may be asymptomatic and cause no discomfort.
When symptoms are present, the boy may report:
In some cases, varicocele is detected because the testicle on the same side appears smaller than the other.
Causes or associated factors
A varicocele is linked to venous reflux, which causes dilation of the blood vessels of the testicle.
During adolescence, growth and developmental changes may make this condition more evident. However, the presence of varicocele does not always mean that surgical treatment is needed.
When to book a consultation
It is advisable to request a specialist assessment if the boy has testicular pain, discomfort or a feeling of heaviness in the scrotum.
A consultation is also indicated when, during a check-up, asymmetry between the testicles is found or there is a suspected slowing of growth of the testicle on the same side as the varicocele.
Assessment and diagnosis
Diagnosis is made through a specialist consultation and, when indicated, a testicular ultrasound scan.
The consultation makes it possible to assess the presence and grade of the varicocele, while ultrasound allows the size of the testicles to be measured and checks for any testicular hypoplasia, meaning a reduction in the volume of the affected testicle.
How it is treated
Not all varicoceles need surgery.
Treatment is assessed mainly when the varicocele is symptomatic or when there is asymmetry of the gonads, meaning a difference in size between the two testicles.
In asymptomatic cases without changes in testicular growth, clinical and ultrasound monitoring over time may be indicated.
When surgery is needed and what it involves
Varicocele correction is indicated in symptomatic cases or when testicular asymmetry is present.
Treatment may be performed using different techniques:
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- ● Traditional open surgery;
● Laparoscopic surgery;
● Radiological scleroembolisation.
Dr Rapuzzi performs and recommends, when indicated, laparoscopic varicocele correction. This procedure aims to interrupt the venous reflux responsible for the varicocele.
Admission is generally as day surgery, and the procedure is performed under general anaesthesia.
Recovery and useful instructions
After treatment, Dr Rapuzzi generally recommends.
In cases of lichen sclerosus, long-term urological follow-up is indicated to monitor the development of the condition and any involvement of the external urethral opening.
Parents’ most common questions
No. Not all varicoceles require surgery. Correction is assessed mainly when there are symptoms, pain or discomfort, or when asymmetry between the testicles or a reduction in the volume of the affected testicle is observed.
Yes. In some cases, varicocele may cause pain, discomfort or a feeling of heaviness in the scrotum. In other cases, it is asymptomatic and is discovered during a check-up.
Diagnosis is made through a specialist consultation and, when indicated, with a testicular ultrasound scan.
Treatment is considered if the varicocele causes symptoms or if there is a reduction in the volume of the affected testicle.
Correction may be performed using open surgery, laparoscopic surgery or radiological scleroembolisation. The pathway is chosen according to the individual case and specialist assessment.
In general, it is advisable to avoid physical activity and sport for about 30 days, unless otherwise indicated by the specialist.
Note: the information on this website is provided for guidance only and does not replace a specialist medical assessment. In case of acute symptoms, significant pain or a worsening general condition, you should contact a doctor or go to the emergency department.
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