Many times the swelling will be present when standing but will disappear when the man lies down. The degree of pain, discomfort or swelling will vary from person to person. In fact, some may not have any discomfort at all while others may have significant pain. Men may first notice a varicocele directly after puberty and before the age of 35. Any man can be affected, although it seems to be more frequent in individuals who are tall and thin or who live in very hot climates.
When a man presents to his primary care physician with these complaints most diagnoses can be made with medical history and a thorough physical examination. Sometimes an ultrasound is ordered if there is any doubt about the diagnosis or in order to confirm that there are no other growths present at the time. The varicocele can be large or small. Prominent ones can be easily seen with the naked eye. Small varicoceles may require the use of a Doppler in order to visualize the internal organs. A thermogram is a procedure which detects pockets of heat that may be used in order to diagnose a varicose vein in the scrotum. (15)