Any swelling or lump in the scrotum must be taken seriously as testicular cancer is the commonest malignancy in younger men. Fortunately the vast majority of swellings turn out to be nothing serious, simple cysts being the commonest cause. An ultrasound scan can provide reassurance that there is no serious problem. Another common benign (non-cancerous) swelling is a varicocele which is essentially varicose veins affecting the testicular veins, usually on the left side.
A varicocele may present as a swelling (sometimes described as a ‘bag of worms’) or dull aching discomfort that may be worse on standing for long periods or on straining. It is more of a nuisance than a serious medical problem but can be associated with a reduced sperm count and fertility problems (it is thought due to the heating effect of the distended veins on the testicle). The underlying problem is often incompetence of valves higher up in the veins where they run up towards the left kidney. This allows blood to reflux and pool down into the scrotal veins instead of flowing back up towards the kidney and the heart.
Traditional treatment of a varicocele was open surgery to tie the veins off in the groin. Interventional radiologists can now offer a minimally invasive day case procedure performed under local anaesthetic and x-ray guidance called embolisation which blocks the reflux in the testicular veins by placing small metal coils in the vein higher up. This stops the reflux and relieves the swelling and discomfort in most cases. Unlike open surgery the patient goes home a few hours later and is back to normal activity virtually immediately.
Dr. Crowe offers varicocele embolisation to private patients at the Priory Hospital in Birmingham and at the Princess Grace Hospital in London and the procedure is covered by all major heath insurers. For more information see links or to make an appointment please use the contact form or speak to Dr. Crowe’s secretary on 0121 448 1502