Varicocele thrombosis is a rare condition in which a cluster of dilated veins in the scrotum develops a blood clot. Treatment options range from anti-inflammatory medications to surgery.
A varicocele is a collection of veins in the scrotum that are unusually dilated or swollen, not unlike varicose veins that can develop in the legs. A varicocele thrombosis is the clinical term for a blood clot that develops in one of those veins.
A varicocele thrombosis can lead to swelling and pain, usually on one side of the scrotum. Doctors may treat it conservatively or, if the condition is severe, with surgery to remove part of the affected vein.
Clots can develop in arteries and veins throughout the body. They may be small and dissolve before they become problematic, or they may become life threatening, depending on their size and location.
The network of veins in the scrotum is known as the pampiniform plexus. These veins carry blood from the testis and epididymis, a duct that carries sperm, within the scrotum back toward the heart. When a cluster of these veins becomes unusually enlarged (dilated), it’s called a varicocele.
Research suggests that about
Much less common is a spontaneous varicocele thrombosis. The term “thrombosis” refers to clot formation in a blood vessel. If a clot forms in a varicocele, blood flow back to the heart is blocked or reduced, often leading to swelling and other symptoms.
In 2014, a report suggested that fewer than 25 cases of varicocele thrombosis had been reported in medical literature at that time.
Scrotal pain is often the first symptom of varicocele thrombosis. The pain is
The condition may also cause swelling in the scrotum. In addition, you may feel the varicocele if the section of affected veins is large enough. The clump of veins may feel like a small lump of worms or spaghetti.
Like clots that form in other veins, varicocele thrombosis is often the result of a valve in the vein that doesn’t work properly. This faulty valve allows blood to flow backward and pool within the vein, but it’s not always clear why it malfunctions.
Trauma to the scrotum, which may develop as a complication of another health problem or a procedure, such as hernia surgery, may also lead to circulation problems like varicocele thrombosis.
Some people are more prone to blood clot formation (coagulation), meaning that they may be more likely to develop clots anywhere. You may be genetically predisposed to blood clots.
Also, as with varicose veins in the legs, having overweight or obesity may increase the risk of varicocele thrombosis slightly.
A physical examination of the scrotum, as well as the penis and lower abdomen, can help narrow the likely cause of symptoms and rule out other potential causes.
However, imaging is usually necessary to formally diagnose varicocele thrombosis. Ultrasound is the preferred screening option for varicocele thrombosis.
Once a doctor has diagnosed a varicocele, the first approach is usually a conservative treatment plan. This may include anti-inflammatory medications and anticoagulation therapy.
You usually only take oral anticoagulant medications for a limited time, as they can increase the risk of bleeding complications while they help prevent existing clots from growing larger. The hope with a conservative approach is that the clot will shrink and eventually dissolve into the bloodstream, allowing healthy circulation to resume.
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This surgery does come with some potential complications, such as bruising or injury to a nearby blood vessel.
Without treatment, varicocele thrombosis can lead to potentially severe outcomes, including pain, infertility, and the death of tissue within the scrotum. However, if conservative treatment relieves symptoms and helps restore healthy circulation to and from the scrotum, the outlook is very promising.
If surgical repair of the varicocele is necessary, the outlook is also encouraging. A 2017 review of people who had varicocele repair suggests that more than 90% experienced pain relief and healthier circulation.
How do you treat testicular thrombosis?
Initial treatment may include anti-inflammatory medications and rest (with the scrotum elevated). If symptoms linger, getting surgery to remove part of the affected vein (or veins) may be necessary.
What is the common complication of varicocele?
In addition to pain and discomfort in the scrotum, two major complications include
What are the symptoms of spermatic vein thrombosis?
One of the main symptoms is acute pain, usually on the left side of the scrotum. Scrotal swelling may also occur.
Even though varicocele thrombosis is a rare condition, it’s still important to check your scrotum occasionally for changes that might indicate a circulation problem or testicular cancer.
It’s also important to seek a medical evaluation promptly if you experience pain, swelling, or other symptoms involving the scrotum.