A 14-year-old male presents to the pediatric urology clinic with a complaint of a painless, swelling in his left scrotum that he first noticed several months ago. His mother mentions that the swelling has gradually increased in size, but the child does not experience any pain or discomfort. The patient has no history of trauma or urinary issues and is otherwise healthy.

On physical examination, the left scrotum is noted to have a "bag of worms" appearance, and the swelling is soft and compressible. The scrotal mass becomes more prominent when the patient is standing and reduces in size when the patient lies down. The right scrotum appears normal. There is no tenderness or redness, and the testicles feel normal.

A Doppler ultrasound of the scrotum is performed, which reveals dilated veins in the pampiniform plexus consistent with varicocele. There is no evidence of testicular atrophy, and blood flow to the testicle appears normal. Based on the clinical findings and imaging results, the diagnosis of varicocele is confirmed.

The patient is informed that varicocele is often asymptomatic and commonly seen in adolescents. Given that there are no significant symptoms or complications, the decision is made to observe the condition with follow-up visits to monitor for any potential changes. If the varicocele worsens or causes symptoms in the future, surgical intervention may be considered.