Varicocele Symptoms and Treatment Options for Adolescents: What You Need to Know
Separating the boys from the men
I’ve written before in my blog about varicoceles, which are swollen veins next to the testicles. But I generally write about varicoceles from the perspective of grown men. Although the likelihood of developing a varicocele increases with age, a varicocele can develop any time after puberty, which means that they can occur in adolescents. So this blog is mainly for young men and their parents.
First, a bit of explanation. Veins carry blood from the testicles back to the heart, and valves in the veins keep the blood from flowing backward. If any of these valves fail, some of the blood flows in reverse. This backup causes the veins to swell. These swollen veins are called varicoceles and they’re fairly common among young men. That’s because during puberty, the testicles grow quickly and need more blood. Sometimes the veins can’t handle the extra blood.
Varicocele symptoms in adolescents
In most cases, varicoceles have no symptoms, so you won’t know if you have one or not. When symptoms do occur, they can be during hot weather, after exercise, or after standing or sitting for a long time.
Varicocele symptoms include an ache or heavy feeling in the testicles or a feeling that one testicle is larger than the other. The varicocele itself may feel like a bag of worms, and it’s usually (but not always) on the left side because there’s more blood flow on that side. If you have any of these symptoms, you should see a urologist for a testicular exam and varicocele diagnosis.
Varicocele treatment options for boys and adolescent men
Varicoceles occur in about 15% of all young men, so they’re pretty common. They’re often harmless, but they’re not something you should ignore or try to treat on your own. In mild cases, you might be prescribed medication to relieve the pain, or your urologist might suggest snug underwear for support. There are also a variety of surgical options that block blood flow to the veins that aren’t working properly, or the surgery can redirect blood flow to veins that are working properly. These surgeries are pretty common and relatively simple.
So the big question is whether you need varicocele surgery or not. The answer is usually related to how serious the varicocele is. In serious cases, an untreated varicocele in an adolescent can result in undersized testicles, lower semen volumes, lower sperm counts, a lopsided scrotum, and misshapen sperm. In other words, it can look strange, stunt your growth and make it more difficult to have children. This can be the result of a “high-grade varicocele,” which occurs in about 5% of all adolescent men. They can also occur in boys before puberty, but this is rare.
To determine whether an adolescent with a varicocele is a candidate for surgery, a urologist may evaluate pain levels, varicocele size, whether there’s more than one varicocele, testicle size (especially one testicle compared to the other), vein diameter, and tests for various hormone levels. A semen test may also be conducted. Another thing to consider in deciding the treatment plan that’s right for you is whether this is the first varicocele or if you’ve already been treated. (Varicoceles develop again after surgery in up about 10%-15% of cases.)
If it’s decided that an adolescent should have varicocele surgery, the thing to determine is which type of surgery should be used. There are several types of varicocele surgeries. Some are recommended for adolescents and some are not, so be sure that your urologist knows all the options. And if you’re not getting answers to all your additional varicocele questions, find a urologist who has experience with treating adolescents. Remember that a high-grade varicocele that is left untreated or is treated with a poorly chosen surgical option can result in long-term health issues.