Marylebone Diagnostic Centre · Men’s Health
Varicocele Symptoms: Grades 1–3 Explained
Understand testicular swelling, fertility concerns and your next steps with Marylebone Diagnostic Centre.
A varicocele is a group of enlarged veins around a testicle, usually on the left. It may cause a dragging ache, heaviness or a soft “bag of worms” feeling. Some men have no symptoms.
To arrange a consultation with Mr Giulio Garaffa, Consultant Urological Surgeon, contact MDC on WhatsApp 07495 970109 . Our staff can help with booking, relevant tests and follow-up.
73 Baker Street, London W1U 6RD · Appointment availability and consultation location confirmed when booking
Varicocele grade 1–3 symptoms explained
The clinical grade describes how easily a clinician can feel or see the enlarged veins. It is not a pain score or a fertility diagnosis.
| Grade | Examination finding | Possible symptoms |
|---|---|---|
| Grade 1 Small | Felt only when bearing down during a clinician-guided Valsalva manoeuvre. | Often unnoticed, without visible swelling. Discomfort can still occur. |
| Grade 2 Moderate | Felt without bearing down, but not visibly obvious. | Possible aching, heaviness or a soft cluster of veins. Some men have no symptoms. |
| Grade 3 Large | Visible and palpable without bearing down. | More noticeable veins or a “bag of worms” appearance. May be painless or uncomfortable. |
Symptoms can overlap between grades. Aching may worsen after standing or activity and ease when lying down. A smaller affected testicle or fertility difficulty also warrants assessment. You cannot reliably grade a varicocele yourself.
Your questions, answered clearly
What is the varicocele “bag of worms” feeling?
It describes soft, winding veins above or around the testicle. They may feel like a cluster of small tubes and become more noticeable when standing.
It does not mean there are actual worms. A hard lump within the testicle is not a typical varicocele finding. Have any new lump examined rather than assuming its cause.
What should I do about a sudden right-sided varicocele?
Seek prompt medical assessment. A newly appearing right-sided swelling, especially one that does not reduce when lying down, needs examination.
An isolated right-sided varicocele may require further investigation of venous drainage or abdominal causes. It does not automatically mean cancer. If pain is sudden or severe, follow the emergency advice above.
Can varicocele cause low sperm count?
Yes, in some men. Varicoceles can affect sperm production and quality, possibly through increased testicular temperature. Many men with a varicocele still conceive naturally.
Semen analysis at MDC checks sperm numbers, movement and shape. Results should be interpreted alongside your medical history and examination.
Does varicocele cause erectile dysfunction?
A direct causal link is not established. Some men with varicocele have low testosterone, but erection difficulties can also relate to blood flow, stress, medication and other health conditions.
A consultation can help identify which checks are relevant. Treating a varicocele does not guarantee better erections.
Specialist assessment · Book through MDC
Arrange a consultation with Mr Giulio Garaffa
Mr Giulio Garaffa, Consultant Urological Surgeon, can assess your symptoms, discuss fertility or erection concerns, and advise on appropriate investigations and treatment options.
WhatsApp MDC on 07495 970109 or call 020 7724 0540 to arrange your appointment.
Our staff will explain fees and availability, help you book and confirm the consultation location. You do not need to choose a test package before speaking to us.
Already have semen results, blood tests or an ultrasound report? Tell our staff so they can explain how to provide your existing reports for the consultation.
A clear pathway, with follow-up
From your first enquiry to reviewing results, MDC can help coordinate the next appropriate step.
Contact our team
WhatsApp MDC on 07495 970109 or call us. Explain whether your concern is swelling, discomfort, fertility or erections. Our staff can help arrange the appropriate appointment.
Have a specialist assessment
Your clinician will discuss your symptoms and medical history and examine you. A scrotal Doppler ultrasound may be recommended where further clarification is needed.
Arrange relevant tests
Your clinician may recommend semen analysis, hormone blood tests or other investigations. MDC staff can help coordinate the recommended tests. Not everyone needs every test.
Review results and plan ahead
Agree how results will be explained and when a review is needed. The plan may involve monitoring, repeat testing or referral for treatment. Our team can help arrange follow-up appointments.
Does every varicocele need treatment?
No. A confirmed varicocele without troublesome symptoms or fertility concerns may be monitored. Supportive underwear and advice about suitable pain relief can help mild discomfort.
For persistent symptoms or selected fertility problems, a specialist may discuss microsurgical repair or embolisation, which closes off affected veins. Benefits, recurrence and procedural risks should be discussed. Improved fertility or pain relief cannot be guaranteed.
MDC can support assessment and referral. Surgery or embolisation would require arrangements with the appropriate treatment provider.
MDC services to support your next steps
Our Baker Street clinic brings together diagnostic testing and men’s health support, alongside access to specialist urology assessment. Your clinician can help identify which services are relevant to you.
Urology consultation
Discuss swelling, discomfort, fertility or sexual health concerns with our specialist. Contact MDC staff to arrange your appointment.
WhatsApp MDC: 07495 970109 →Semen analysis
Check sperm numbers, movement and shape when fertility is a concern. An abnormal result may need repeating and further clinical review.
Explore semen analysis →Relevant blood tests
Hormone tests such as testosterone, FSH and LH may be appropriate after assessment. Wider health checks can be selected according to your symptoms and history.
Browse MDC blood tests →Sperm DNA fragmentation
An additional investigation for selected fertility situations. Your clinician can explain whether it would add useful information to your assessment.
Learn about DNA fragmentation →Ultrasound arrangements
If your specialist recommends a scrotal Doppler ultrasound, our team can help with the next steps and confirm availability, location and fees.
Ask MDC about scan arrangements →Men’s and sexual health
Tell us about erection difficulties, urinary symptoms or sexual health concerns so the appropriate consultation or testing can be arranged.
Explore men’s health services →MDC also offers shockwave therapy for selected men’s health conditions . Your specialist can discuss whether it has a role in your care, including the evidence, limitations and alternatives.
Take the next step: contact MDC
To arrange a consultation with Mr Giulio Garaffa, Consultant Urological Surgeon, WhatsApp MDC on 07495 970109 or call our team.
Our staff will help you book, explain the appointment options and confirm fees. We can also help coordinate the tests and follow-up recommended after your assessment.
Marylebone Diagnostic Centre73 Baker Street
London W1U 6RD
Contact details and appointment enquiries
WhatsApp is for routine enquiries, not emergencies. Please avoid sending sensitive medical documents unless our team directs you to an appropriate secure channel.
Clinical sources and information
This page provides general information and does not diagnose the cause of a lump, swelling or testicular pain. Assessment and treatment depend on your individual circumstances.
- European Association of Urology: male infertility and varicocele
- NHS: testicle pain and urgent advice
- Mayo Clinic: varicocele symptoms and causes
- Cleveland Clinic: varicocele, fertility and erection concerns
- Guy’s and St Thomas’: varicocele embolisation
- European Association of Urology: erectile dysfunction management
