Variocele and Hydrocele

Dear OncoLink "Ask the Experts,"
It would be useful if you could post some information relating to the co-incidence of variocele/hydrocele and testicular cancer since:

1. It is unclear what, if any, relationship exists between them
2. Information about testicular self-examination techniques for people who have either variocele or hydrocele

Kenneth Blank, MD and John Han-Chih Chang, MD, Editorial Assistants for Oncolink, respond:

Thank you for your interest and your question.

Hydrocele is a fluid-containing sac that arises in the lining of the testis. Variocele is dilation (enlargement) of the spermatic veins. Both of these conditions can mimic testicular cancer as they occur as masses near the testis.

The only clear risk factor for development of testicular cancer is cryptorchidism (undescended testis). Other risk factors that have been suggested in small reports but not confirmed in larger trials include HIV infection, viral infection of the testis, and vasectomy. We are not aware of any association between the development of testicular cancer and either variocele or hydrocele.

Small varioceles or hydroceles may allow testicular self-examinations but larger ones may obscure palpation (feeling of) the testis. In the latter situations, there are several option for men to continue careful screening for testicular cancer. One option is surgical excision of the variocele or hydrocele. Another option is yearly ultrasound examinations, and a third option is checking bloodwork for laboratory values that may be elevated in some testicular cancers (e.g., Beta-HCG and alpha fetoprotein).

We recommend that you discuss these options with your urologist.

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