A 32-year-old man came to my OPD with his wife. Married for three years, still no child. His semen report was weak, and the ultrasound showed a varicocele on the left side. His wife asked the first question: “Doctor, what should we do? Is an operation the only way?”
The answer is no. In this page I will tell you what a varicocele is, the 3 questions that decide if you need treatment, and how it can be treated without an operation.
हिंदी में समझें: वैरिकोसील क्या है और इलाज कब ज़रूरी है?
वैरिकोसील यानी अंडकोष (testis) के ऊपर नसों का गुच्छा। नसों के अंदर के वाल्व खराब हो जाते हैं, खून वापस आकर जमा होने लगता है और वहाँ गर्मी बढ़ जाती है, जिसका असर sperm पर पड़ सकता है।
हर वैरिकोसील का इलाज ज़रूरी नहीं है। खुद से ये 3 सवाल पूछिए:
- क्या दर्द या भारीपन आपकी रोज़ की ज़िंदगी पर असर डाल रहा है?
- क्या आप बच्चे की कोशिश कर रहे हैं और semen report खराब आई है?
- क्या उस तरफ़ का अंडकोष छोटा हो रहा है?
तीनों का जवाब "नहीं" है तो सिर्फ़ follow-up काफ़ी है। एक भी जवाब "हाँ" है तो इलाज के बारे में बात कीजिए।
Embolization से इलाज: बिना चीरा, बिना टांके, local anaesthesia में। ज़्यादातर मरीज़ उसी दिन घर चले जाते हैं।
अपनी ultrasound और semen report WhatsApp कीजिए: 95200 77033
What is a varicocele? (नसों का गुच्छा)
Around each testicle there is a net of small veins. Their job is to carry used blood back up towards the heart. Inside these veins are tiny one-way valves, like the flap in a drain pipe that stops water from flowing back.
When these valves stop working, blood flows backwards and pools around the testicle. The veins swell up into a bunch, which is why it is called नसों का गुच्छा. This pooled blood also raises the temperature around the testicle, and sperm are sensitive to heat.
Varicocele is much more common on the left side. The left vein is longer and joins the kidney vein at a sharp angle, so the pressure on its valves is higher.
Symptoms of varicocele
- A dull ache or heaviness in the scrotum, worse after standing or exercise and better when you lie down
- Veins you can see or feel above the testicle, often described as a “bag of worms”
- The testicle on that side becoming smaller
- Difficulty in having a child, or a low sperm count or poor sperm movement on a semen test
Many men have no symptoms at all. Their varicocele is found during a check-up or an infertility workup.
Do you need treatment? Ask yourself 3 questions
I will be honest with you: not every varicocele needs treatment. Yes, even as an interventional radiologist, I am telling you this. Ask yourself:
- Is the pain or heaviness affecting my daily life or work?
- Are we trying for a child, and is my semen report abnormal?
- Is the testicle on that side getting smaller? This matters especially in teenage boys.
Varicocele treatment without surgery: embolization
In embolization, I reach the faulty vein from inside. Under local anaesthesia, a very thin tube enters a vein, usually in the neck or groin, through a pinhole. Using X-ray as a guide, it is guided to the leaking vein, and the vein is closed with tiny coils or a special medical glue. The blood then takes the healthy route back to the heart.
No cut. No stitches. Most patients walk home the same day.
Embolization vs surgery: a fair comparison
| Embolization | Surgery | |
|---|---|---|
| Cut and stitches | No, only a pinhole | Yes, a small incision |
| Anaesthesia | Local | Usually spinal or general |
| Hospital stay | Usually home the same day | Same day to 1 day |
| Back to light work | Usually in 1–2 days | Usually in about a week |
| Both sides at once | Yes, through the same pinhole | Needs an incision on each side |
Both methods treat varicocele, and both have their pros and cons. Which suits you depends on your scan, your symptoms and your preference, and we decide that together.
What happens on the day
- Consultation: I examine you and look at your Doppler ultrasound and semen report.
- The procedure: local anaesthesia, a pinhole, then the faulty vein is closed under X-ray guidance. You stay awake and comfortable.
- Rest and home: a few hours of rest, then most patients go home the same day.
- Follow-up: light work in a day or two, heavy exercise after about a week, and a repeat semen test usually around three months later.
4 common myths about varicocele
Myth 1: “Exercises or yoga will cure my varicocele.” Wrong. Exercise is good for health, but it cannot repair a broken valve inside a vein.
Myth 2: “Every varicocele causes infertility.” Wrong. Many men with a varicocele become fathers without any treatment. That is why the 3 questions above matter.
Myth 3: “Only the wife needs to be tested.” Wrong. When a couple cannot conceive, the husband should be tested too. A simple semen test and scrotal ultrasound can find the problem.
Myth 4: “The coils and glue left inside are dangerous.” They are made for use inside the body and have been used in blood vessels for many years. I explain this in detail in the video below.
Mistakes to avoid
- Spending months on unproven remedies when you are trying for a child. Time matters, especially for your wife's age.
- Ignoring a testicle that is getting smaller in a teenage boy.
- Agreeing to an operation without first asking: do I really need treatment?
Watch: varicocele explained
Questions patients ask me
Is varicocele embolization painful?
It is done under local anaesthesia through a thin tube, so you feel only a small prick. Most patients have mild discomfort for a day or two.
Does every varicocele need treatment?
No. If there is no troublesome pain, no fertility problem and no shrinking of the testis, regular follow-up is usually enough.
Will treatment improve my sperm count?
In many men with an abnormal semen report, sperm quality improves after treatment, but results differ from person to person. A repeat semen test is usually done about three months later.
Can a varicocele come back after treatment?
It can come back after any treatment, surgery or embolization. If it does, it can usually be treated again.
How soon can I go back to work?
Most patients go home the same day and return to light work within a day or two. Heavy exercise is usually avoided for about a week.
Is varicocele embolization covered by insurance?
Yes, it is covered by health insurance.
Varicocele ka ilaj bina operation ho sakta hai?
Haan. Embolization mein ek patli tube se, bina chira aur bina taanke, kharab nas ko andar se band kiya jaata hai. Zyaadatar mareez usi din ghar chale jaate hain.
Kya varicocele se bachcha hone mein dikkat hoti hai?
Har varicocele se nahi. Kuch purushon mein yeh sperm ki quality kam kar sakta hai. Isliye semen test aur scrotal ultrasound se pehle jaanch karna zaroori hai, phir hi ilaj ka faisla karein.
In short
- A varicocele is a bunch of swollen veins caused by broken valves. It is common, and it is often harmless.
- Ask the 3 questions about pain, fertility and testis size. If all three are no, monitoring is enough.
- If you need treatment, embolization fixes it without a cut or stitches, and you usually go home the same day.
Not sure if you need treatment? Send your ultrasound and semen report on WhatsApp and I will guide you.
WhatsApp 95200 77033
Written by Dr. Amol Srivastava
MBBS, MD (UCMS), PDCC (Interventional Radiology). Consultant Interventional Radiologist, Lucknow. OPD Monday to Saturday, 9 am to 7 pm.
Last reviewed: November 2026. This page is for information and does not replace a consultation.