Diagnosis of Varicocele

A patient suspected of having a varicocele should be examined while standing up—as a varicocele is more prominent in this position than while lying down. Large varicoceles may be seen with the naked eye. Medium-sized varicoceles may be detected during physical examination by feeling (palpating) the scrotal area.

Small varicoceles may be discovered by a physician using one of the following procedures.

  • Doppler ultrasonography uses ultrasound echos to detect the characteristic sound of the backflow of blood through the valve.
  • Thermography uses infrared sensing technology to detect pockets of heat caused by pooled blood.
  • Venogram is an outpatient procedure performed under local anesthesia. The physician makes a small puncture in the groin and then injects a special dye into the spermatic vein. The dye in the bloodstream enables the physician to see the anatomy in the vein on x-ray and detect the presence of a very small varicocele.

If the patient is being examined for suspected infertility, the physician usually performs a comparison of semen samples. Infertility caused by a varicocele typically produces a consistent pattern of low sperm count, poor sperm motility (movement), and abnormal sperm morphology (e.g., immature, incompletely developed, damaged, dead, or dying sperm).

Publication Review By: David M. Kaufman, M.D., Stanley J. Swierzewski, III, M.D.

Published: 09 Jun 1998

Last Modified: 13 Oct 2015