A male condition

A varicocele (VAR-ih-koe-seel) is an enlargement of the veins within the scrotum. A varicocele is similar to a varicose vein that can occur in the legs or in the female pelvic area. 15% of the general male population suffer from varicocele with more than 80% occurring on the left side and the remainder on both sides. They are generally acquired during puberty.

Most varicoceles are asymptomatic; however, some can cause scrotal pain. This pain is generally mild to moderate, occurs with long periods of sitting, standing or activity and is relieved by lying down. Although it can be uncomfortable before bedtime (after a long day of activity), it generally does not occur upon awakening after a night’s rest. The pain is dull, congestive‚ “tooth ache” like and generally doesn’t refer elsewhere. The resulting backup causes the veins to widen (dilate) which can lead to damage to the testicle and result in worsened fertility. Our physicians can provide targeted treatment for varicocele called “varicocele repair.”
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  • Pain varying from sharp to dull discomfort
  • Pain increasing with standing or physical exertion, especially over long periods
  • Pain worsening over the course of a day
  • Pain relief when you lie on your back

Patient Story

Pelvic Venous Congestion (PVCS)

Pelvic venous congestion syndrome (PVCS) also known as ovarian vein reflux, causes chronic pelvic pain in approximately 13-40% of women. The ovarian veins carry venous blood from the ovaries and pelvis up to the level of the renal veins in the abdomen. All veins have valves to help guide blood flow back up towards the heart. When these valves become damaged or dysfunctional, some blood flows backwards causing the veins to become engorged or “congested,’ leading to varicose veins. PVCS is essentially varicose veins in the pelvis due to venous insufficiency in the ovarian veins. These internal varicose veins can cause chronic, debilitating pain. This pressure may also cause visible varicose veins around the vulva, vagina, inner thigh, sometimes the buttocks, and down the leg(s).

PVCS signs and symptoms

  • Pelvic pain or aching around the pelvis and lower abdomen
  • A “dragging” sensation or pain in the pelvis
  • Feeling of fullness in the legs
  • Pain following sex
  • Pain during menstrual periods
  • Worsening of stress incontinence
  • Worsening in the symptoms associated with irritable bowel syndrome

The cause of the dilated ovarian/pelvic veins in PVCS is poorly understood. PVCS most commonly occurs in young women, and usually in women who have had at least 2-3 children. Because many women experience relief of symptoms when lying down, PVCS often goes unnoticed during the typical ultrasound, causing women to often go years before the true cause of their pain is diagnosed. Our physicians can provide tailored diagnostics and treatment to eliminate PVCS and help those suffering from PVCS enjoy a life free of pain. Learn more about our treatment options. 

Pelvic and Labial Varicose Veins

Pelvic varicose veins and labial varicose veins are forms of venous insufficiency by which women’s pelvic, labial, or vulvar veins become enlarged and dilated during pregnancy and continue after the baby has been delivered. Such varicosities often worsen with each pregnancy. Some women develop frequent or continuous pain from labial varicosities prominent during pregnancy and improve after the baby is born. Labial varicose veins may be due to iliac vein obstruction from compression or old clots, or they may be due to ovarian vein reflux with pelvic venous insufficiency. In some patients, the primary problem is reflux (abnormal reversal of flow) in the veins of the deep pelvis through veins near the vagina into the labia and surrounding tissues. Like with all types of venous reflux disease, our physicians provided targeted treatments that divert blood flow through healthy veins and eliminate discomfort.
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What to expect | Your first appointment will involve the following


Your treatment will being with an ultrasound examination of your veins, arteries, or both, in your legs to diagnose the presence and extent of disease. Your test results will be immediately available to review with the doctor.

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Consult with the doctor

Once we review the results of your diagnostic tests, our physicians will help you develop a plan to provide you with the best treatment for your disease.

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Love this place, the staff and the Doctors. They help people that might otherwise have a greater problem! Very professional, answers all questions. Provides information so that patients understand.
Great vascular surgery facility in Orange County. Their doctors are great. Office looks very nice. Staff is really helpful and kind.

They take the time to understand the problem. You will feel like you are in very caring hands.

My experience at Pedes Orange County has been great! I have no complaints. Dr. Goldstein and Dr. Hewett have been professional in explaining my procedures and treatment plan. I have even recommended your office to my friends and people I know from church. Gregg and David (Ultrasound techs) have treated me well and the rest of the staff has been very helpful.