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Varicocele might be noticed as soft lumps, usually above the testicle and mostly on the left side of the scrotum. [5] Right-sided and bilateral varicocele does also occur. Men with varicocele can feel symptoms of pain or heaviness in their scrotum. [5] Large varicoceles present as plexus of veins and may be described as a "bag of worms".
While varicocele is the diagnostic term for swelling in the valveless venous distribution of the male pampiniform plexus, this embryological structure, common to males and females, is often incidentally noted to be swollen during laproscopic examinations in both symptomatic and asymptomatic females. [2]
During a genital examination, the doctor can detect any of the following: structural abnormalities (ex. varicocele), urethral opening abnormalities, problems related to not being circumcised (ex. phimosis), [3] lumps, tumors, redness, excoriation, edema, lesions, swelling, cancer, hair-related issues, and many others.
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An unusual manifestation of NCS includes varicocele formation and varicose veins in the lower limbs. [9] Another clinical study has shown that nutcracker syndrome is a frequent finding in varicocele-affected patients and possibly, nutcracker syndrome should be routinely excluded as a possible cause of varicocele and pelvic congestion. [10]
Other than the legs, in men it can also occur in the scrotum (usually on the left side) where it is called a varicocele. This develops because the left testicular vein brings blood back to the left renal vein at about a 90-degree angle, while the right testicular vein drains directly into the inferior vena cava.