An abnormality of the normal descent of the testis, which may be present at birth (congenital) or develop later in life (ascending).
Normally, each testis develops inside the abdomen, and subsequently descends to its final position in the scrotum.
In congenital abnormalities this process fails, leaving the testis in the groin, or even inside the abdomen from birth. Surgical correction (orchidopexy) is required, and current recommendations advise prior to one year of age.
In acquired variants, the testes were originally down at birth, but subsequently ascend and stay in the groin. Surgery is also recommended, though the timing is thought not to be as critical.
Surgery is performed as a day case via a small incision in the groin and scrotum in most cases, or occasionally keyhole surgery when the testis is still in the abdomen.
Commonly found in teenagers, varicocele is a disorder of some of the vein leading to the testis. The veins dilate and give an appearance in the scrotum described as a "bag of worms". Usually asymptomatic, occasionally they may present as with dull aching pain in the scrotum.
The management of paediatric varicocele has been debated for many years, mainly revolving around the potential effects on the testis and fertility. Most often close observation is undertaken, though occasionally minimally invasive surgery is indicated. Your surgeon will discuss the options with you.