Why varicoceles in men may increase risk of heart disease

A condition affecting about 15 percent of men may raise their risk of developing heart disease and diabetes, according to a new study.  Varicoceles is a condition in which veins inside the scrotum of men become enlarged, similar to developing a varicose vein in a leg.  The scrotum is a sac holding the testicles and is part of the male reproductive system that makes, stores, and moves sperm. The testicles make both sperm and testosterone. Sperm that are in the process of maturing will move through the epididymis, a coiled tube behind each testicle.

A 2023 study wanted to research if men with high-grade varicoceles had a greater risk of heart disease and metabolic syndrome.  Men with varicoceles tend to have low testosterone and having low testosterone has been associated with heart disease.  

For the research, scientists analyzed medical records of male patients between ages 18-50 with high-grade and left varicocele from two different urology and two different cardiology clinics from November 2021 to August 2022. What was found was a strong correlation between varicoceles and heart disease and hemodynamic impairments which could include high blood pressure, heart failure, and peripheral artery disease.  

What are varicoceles?

To understand varicoceles, it is essential to know that there is a group of connected veins that drain blood from the testicles called pampiniform plexus.  The pampiniform plexus purpose is to help cool the blood in the testicular artery before warm blood enters the testicles preventing it from harming sperm.

If the pampiniform plexus veins in the scrotum enlarge, this is known as varicoceles.  During puberty is when most varicoceles can form and can become larger and easier to notice. They tend to be more common on the left side of the scrotum, however in rare circumstances they can exist on both sides simultaneously.  Around 10 to 15 males out of 100 have a varicocele.  

Most of the times, varicoceles are harmless causing no problems.  

Symptoms of varicoceles

Usually there are no symptoms of varicoceles.  However, they may cause infertility and slow growth of the left testicle during puberty.  For about 4 in 10 men they can be the reason of fertility problems in men.  In men who have been tested for fertility often have varicoceles, but 8 out of every 10 men who have them do not have fertility issues.

Causes of varicoceles

There can be a variety of reasons why a man may have varicoceles:

• Valves in the veins may not be working well
• If blood flow is sluggish, blood may pool in the veins
• In rare cases, swollen lymph nodes or other abnormal masses behind the abdomen may be blocking blood flow

Diagnosing varicoceles

The most common way of diagnosing varicoceles is through self-examining of the scrotum or during a routine doctor’s visit.  Many describe varicoceles by how they look and feel as a “bag of worms.” 

For a urologist to find the enlarged veins of varicoceles, a man will stand and be asked to take a deep breath holding it and bearing down while the doctor feels the scrotum above the testicle.  

 An ultrasound may be ordered to help find the veins usually wider than 3 millimeters.

Treatment of varicoceles

In most cases, varicoceles are left untreated as there are no medications to treat or prevent them.  But treatment may be offered to man who are having fertility problems, pain or if the left testicle is growing more slowly than the right in a child. If a man is having pain then pain killers such as acetaminophen or ibuprofen may be offered.

There might be a correlation between boys with a smaller testicle and a higher risk of fertility problems when they are older.

Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy.  Dr. Samadi is a medical contributor to NewsMax TV and is also the author of The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911.