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By Mayo Clinic staffYour doctor will conduct a physical exam, which may reveal a twisted, nontender mass above your testicle. Some people have described the mass as feeling like a bag of worms. If it's large enough, your doctor will be able to feel it while you're standing up. If you have a smaller varicocele, your doctor may ask you to take a deep breath and hold it while you bear down (Valsalva maneuver). This helps your doctor detect abnormal enlargement of the veins.
If the physical exam is inconclusive, your doctor may order a scrotal ultrasound. This test, which uses high-frequency sound waves to create precise images of structures inside your body, may be used to ensure there isn't another reason for your symptoms. One such condition is a tumor that compresses the spermatic vein.