The main way to differentiate between a varicocele and a hernia is to look at where it occurs; a varicocele occurs above the scrotum, whereas a hernia occurs in the lower part of the abdomen, in the groin. Varicose veins are caused by a malfunction of the valves in the spermatic veins, which causes the veins to reflux blood and become tortuous and dilated. Hernia occurs mainly as a result of the appearance of weak defects in the muscles and muscular membranes of the abdominal wall, and the intestines bulge out of the defects after an increase in intra-abdominal pressure. There should not be much difficulty in making the distinction, but to differentiate between the two disorders it is best to be done by a physician, and the patient’s own distinction may result in a miscarriage of justice.