Bag of worms is a condition characterized by enlargement of the veins within the scrotum. This condition does not have anything to do with worms, but it is often called bag of worms because the scrotum can often feel like carrying a bag of worms. The clinical name for this condition is “Varicocele” pronounced (VAR-ih-koe-seel). According to the Mayo Clinic:
Varicocele is similar to a varicose vein that can occur in your leg. A varicocele may cause:
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Shrinkage of the affected testicle (atrophy). The bulk of the testicle comprises sperm-producing tubules. When damaged, as from varicocele, the testicle shrinks and softens. It’s not clear what causes the testicle to shrink, but the malfunctioning valves allow blood to pool in the veins, which can result in increased pressure in the veins and exposure to toxins in the blood that may cause testicular damage.
Infertility. It’s not clear how varicoceles affect fertility. The testicular veins cool blood in the testicular artery, helping to maintain the proper temperature for optimal sperm production. By blocking blood flow, a varicocele may keep the local temperature too high, affecting sperm formation and movement (motility). Most varicoceles develop over time. Fortunately, most varicoceles are easy to diagnose and, if they cause symptoms, can be repaired surgically.
Symptoms of bag of worms include dull discomfort, feeling of heaviness, sharp discomfort, increased discomfort with sitting, standing or physical exertion (especially over long periods), symptoms worsen during the course of the day, and relief is felt when lying on your back. The condition itself can worsen over time as the varicoceles enlarge.
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Varicocele can often “sneak up” on the individual. As a result, the condition is often discovered during a routine physical exam or fertility evaluation.
How Does Bag of Worms Develop?
Varicoceles or bag of worms typically develops between the ages of 15 and 25. It is unclear exactly what causes varicoceles, but medical professionals believe a varicocele forms when the valves inside the veins in the cord prevent the blood from flowing properly. The resulting backup causes the veins to dilate (widen). Varicoceles typically occurs on the left side. This is likely because of the position of the left testicular vein. Unfortunately, a varicocele in one testicle can affect sperm production in both testicles.
Bag of Worms Treatment
In some cases, bag of worms won’t require any treatment. In these cases, the varicocele might not cause pain, testicular atrophy or infertility. If it does, you may have to undergo
varicocele repair. During varicocele repair, the affected vein is sealed off in order to redirect blood flow into normal veins. Repair methods include open surgery, laparoscopic surgery, and percutaneous embolization.
There are several things you can do to relieve pain and discomfort at home until you get to a doctor. You can take over-the-counter painkillers such as Tylenol, Advil, or Motrin and you can wear an athletic supporter.
For more information about varicoceles (bag of worms), see: