Varicocele

Varicocele:

Varicocele , symptoms and treatment methods and what are the causes of it? What are the possible complications of varicocele? What is its effect on sexual intercourse? How is varicose veins diagnosed? Is it related to delayed pregnancy or male infertility?

What is varicocele?

• The scrotum is the sac covered with skin that holds the testicles.
• It also contains arteries and veins that deliver blood to the gonads.
• An abnormality of the vein in the scrotum may lead to varicose veins.
• A varicocele is an enlargement of the veins within the scrotum.
• Varicose veins occur only in the scrotum and are very similar to varicose veins that can occur in the leg.
• A varicocele can lead to a decrease in sperm production and quality, which may lead to infertility.
• It can also cause the testicles to shrink significantly.
• Varicoceles are common and can be found in 15% of adult males and about 20% of adolescent males.
• Varicose veins generally form during puberty and are more commonly found on the left side of the scrotum.

Symptoms of varicose veins in the scrotum:

Symptoms do not appear in most cases, but in some cases they cause pain, characterized by:

• Unclear pain in the testicles, and sometimes feeling very sharp pain.
• Increasing pain when sitting or standing or doing physical exertion for a long time.
• Pain gradually increases during the day, and reaches its peak at night.
• Decreased pain when lying on the back
• Also, varicose veins have a tendency not to grow with the passage of time, so that they become palpable and disturbing in the testicle.

Varicocele treatment methods:

• Not all cases of varicocele are treated. The cases that are treated are when the varicose veins cause pain or if the testicle atrophies or when it leads to fertility disorders.
• Treatment is usually done by blocking the dilated vein in the testicle and returning blood flow to normal.

Surgery can also be performed in several basic ways:

• Open surgery: This method is the most common, as we reach the testicle through an incision in the abdomen or groin.
• The surgery is also performed under the influence of local or general anesthesia, and during the surgical work we need a microscope in order to reduce as much as possible the possibility of complications.
• The recovery process after surgery is fast, and the pain caused by this process is few.
• Laparoscopic surgery: In this surgery, a small incision is made, and a small camera is inserted through it, and another incision is made to insert the surgical equipment.
• But this surgery is rarely performed because it is associated with anesthesia and with more complications than open surgery.
• Percutaneous embolization: a radiologist intervenes in this surgery, and during this procedure, a catheter is inserted into the veins, so that we see on the radiographic examination that the catheter is in a place, where we can launch small stents to block the expanding vein.
• Also, this surgical method is not widely followed, because it is more complex than other methods, and it also leads to more complications.
• In the event that the varicocele causes a feeling of discomfort, and does not need surgery, it is possible to use medications.
• It is also possible to use elastic underwear, which supports the testicle, which leads to reduce congestion of the veins.

What are the reasons for the formation of varicocele?

• The spermatic cord that carries the testicle contains the veins, arteries, and nerves that support these glands.
• In the healthy veins inside the scrotum, the one-way valves transport blood from the testicles to the scrotum, and then return it to the heart.
• As sometimes the blood does not move through the veins as it should and begins to collect in the vein, which leads to its enlargement.

Possible complications:

• This condition can have an impact on fertility, as varicose veins are present in 35-44% of men with primary infertility.
• It is also found in 45-80% of men with secondary infertility.
• “Primary infertility” is generally used to refer to a couple who have not fathered a child after one year of trying.
• Secondary infertility describes couples who have conceived at least once but are unable to do so again.

What is the effect of varicocele on sexual intercourse and marital relationship?

• Studies on varicocele in all its pathological stages indicate that it does not affect the erection of the penis and the duration of erection at all.
• Rather, it maintains its natural position without change, and thus the intimate relationship is not affected by the man’s varicose veins.
• The risk of developing a varicocele is that it causes a lack of sperm and distorts them, and thus leads to delayed pregnancy or infertility in men .

How is varicocele diagnosed?

• The doctor usually diagnoses the condition after a physical examination, and varicose veins cannot always be felt or seen “when you are lying down.”
• It is also likely that the testicles will be examined when you are standing.”
• The doctor may need to perform an ultrasound of the scrotum, as well as measuring the seminal veins.
• It also allows the doctor to obtain a detailed and accurate picture of the condition, and once varicose veins are diagnosed, it will be classified into one of three cases.
• This is done according to the size of the lump in your testicle, and the size does not necessarily affect the overall treatment because you may not need treatment.
• Treatment options also depend on the degree of discomfort or infertility problems you have.