When it comes to men’s health concerns, the term ‘varicocele’ is one that many may not be familiar with. However, this condition characterized by enlarged veins in the scrotum, can raise questions regarding potential dangers, particularly when it’s on the right side. This article explains what a varicocele is, why it rarely occurs on the right side and how it can be treated.
The term varicocele is applied when the veins in the scrotum (the loose bag of skin that contains the testicles) become enlarged – similar to varicose veins that appear on the legs. The cause of the enlargement is generally malfunctioning valves within the veins in the scrotum.
Your doctor may detect a varicocele during a routine testicular exam or you may see or feel it when you perform a self-exam. Either way, the scrotum may feel or look lumpy, or you may notice raised veins. While a varicocele doesn’t indicate you have a life-threatening issue, it can still impact your life. A varicocele can cause pain and may prevent you from having an active lifestyle. Furthermore, varicoceles can affect both the quality and production of sperm.
Varicoceles occur in around 15% to 20% of all men, and around 40% of males who are evaluated as infertile, will also have it. While varicoceles can appear on the left or right side of the scrotum, it’s quite rare for it to occur on the right.
So, why is that?
In most cases, varicoceles occur on the left side because of the relation of the spermatic vein to the left renal vein. Pain in the left testicle is one of the most common signs of a varicocele although on rare occasions it can be experienced on the right side.
While it’s not necessarily a sign of a serious medical issue, it can indicate an abnormality. For example, there may be a blockage in the abdomen resulting from factors such as blood clots, tumors, or problems with internal organs.
In extremely rare cases, a right-side varicocele may indicate the presence of adrenocortical carcinoma.
Whatever the cause, your doctor may request several abdominal tests.
You should visit your doctor as soon as possible if you notice any lumps or swelling on your scrotum. Be sure to mention if the symptoms are coming from the right side of your scrotum. If your doctor doesn’t order follow-up tests, then it’s wise to seek a second opinion.
Varicoceles are generally easy to detect during an in-office physical exam. But, if in doubt, your doctor may recommend a scrotal ultrasound to confirm the diagnosis. If you have a right-side varicocele, your doctor will order a CT scan to check for abdominal masses or tumors.
If you have an abdominal mass, you will probably be referred to a specialist for further care. The treatment will involve surgery to remove the obstruction and restore normal blood flow to the scrotum.
A treatment plan is usually more straightforward in the absence of abdominal masses. If your varicocele is not causing any pain or fertility issues most doctors recommend watchful waiting. If your varicocele is having a negative effect on your life, then treatment will help.
Varicocele treatment shuts off the affected vein or veins and re-roots blood flow through nearby healthy veins. Closing off the veins causes them to shrink over time and disappear into the body. Laparoscopic surgery and open surgery are treatment options as is varicocele embolization.
This is a minimally invasive treatment typically performed in an outpatient setting by a specialist Interventional Radiologist. Patients benefit from a shorter recovery time and lower risk of complications compared to open surgery. The procedure has a 90% success rate compared to most other surgeries and provides the best of both worlds: successful treatment and speedy recovery.
During the procedure, a small incision is made in the groin to insert a catheter up and into the testicular vein and a venography is carried out to assess the level of damage. Coils or special agents are inserted through the catheter to block or embolize the vein and the blood flow is redirected towards healthy veins. Since the problematic veins are no longer receiving any nutrients from the blood, they shrink and die and are eventually reabsorbed into the body.
Once patients have undergone embolization therapy, they are observed for a few hours and then discharged. Most men return to their jobs or normal daily activities within a few days.
There are several factors to consider before the decision to treat a varicocele is made. These include
While a right-sided varicocele is relatively rare, it's not immune to the potential complications associated with varicoceles in general. Understanding your body and seeking medical advice if you experience any discomfort or concerns is paramount. While right-sided varicoceles may not always be dangerous, addressing them promptly can help mitigate any potential risks and ensure your overall well-being.
If you’re keen to learn more about varicoceles embolization and whether it’s suitable for you, please contact the Midwest Institute for Non-Surgical Therapy (MINT) team.
Photo attribution: image by pressfoto on Freepik
