Varicocele

A healthcare provider can diagnose a varicocele. They’ll review your medical history, ask questions about your symptoms and perform a physical examination.

During the physical exam, your provider may ask you to stand up, take a deep breath, hold your nose and mouth closed and strain to push air out. This is the Valsalva maneuver. They’ll feel your scrotum for enlarged veins as you’re holding your breath and straining.

They may also order the following tests to confirm their diagnosis:

• Pelvic ultrasound. A pelvic ultrasound is a noninvasive imaging test that gives your provider a detailed view of the veins in your testicles. It’s the most common imaging test that providers order to help diagnose varicoceles.
• Semen analysis. During a semen analysis, you’ll masturbate into a special container. Your provider will then send your semen sample to a lab, where technicians will look for the presence and overall health of sperm. A provider will order a semen analysis if there are concerns that a varicocele is impacting your fertility.
• Blood test. During a blood test, your provider will use a tiny needle to withdraw a small blood sample. They’ll send your blood sample to a lab, where technicians will check hormone levels, including follicle-stimulating hormone (FSH) and testosterone.

After confirming the presence of a varicocele, your provider will grade its severity.

What are the grades of a varicocele?

Healthcare providers use grades to detect and score varicoceles:

• Grade 0. This is the smallest type of varicocele. Your provider can’t feel it during a physical exam, but they can see it on an ultrasound.
• Grade I. Your provider can’t see the varicocele, and they can only feel it when you perform the Valsalva maneuver.
• Grade II. Your provider can feel the varicocele even when you’re not performing the Valsalva maneuver, but it’s still not visible.
• Grade III. This is the largest varicocele. Your provider can clearly see and feel it.