Varicocele is a treatable condition. Medical investigation might be recommended in cases where varicocele causes discomfort, pain, or fertility issues.
What is Varicocele?
A common problem is a varicocele; during pubertal age, 15% of the average population has this problem; 35% is the cause of primary infertility, and 75-81% is the cause of secondary infertility. It is the dilatation or incompitence of the pampiniform plexus veins in spermetic cord.
A pouch of skin which holds testicles known as the Scrotum. When the veins that drain blood from the testicles get too big or swollen, blood builds up in the veins and causes pressure or pain in rear cases. Most of the time, varicoceles appear on the scrotum’s left side.
Varicoceles can vary in size and severity. Its severity is determined in grades from 0-3
- G-0 Subclinical,
- G-1 MILD
- G-2 MODERATE
- G-3 SEVERE
Does varicocele lead to erectile dysfunction?
Varicoceles are typically not directly associated with causing erectile dysfunction (ED). But to some extent psychological play a role in causing ED.
Varicocele Symptoms
Symptoms of varicocele are not always noticeable. However, healthcare providers consider the following as symptoms of varicocele:
- Pain & Discomfort in Scrotum. (not common).
- Heaviness and Dragging Sensation.
- Visible Enlargement.
- Infertility.
- Testicular Atrophy.
Varicocele causes
The exact cause of varicoceles is not always clear, but they are often associated with faulty valves in the veins that allow blood to flow in the wrong direction or pool in the veins. Abnormal body mass that puts pressure on veins can also cause varicocele.
Diagnosis
Here are some processes healthcare providers recommend to diagnose varicocele:
- Physical Examination: The doctor will perform a physical examination. The patient is often examined while standing, as this position can make the varicocele more prominent. During the examination, the urologist will see any swelling, enlarged veins, or abnormalities in the scrotum. The “bag of worms” sensation might be felt when the doctor palpates the area.
- Valsalva Maneuver: The Valsalva maneuver involves asking the patient to take a deep breath and bear down as if having a bowel movement. This can increase intra-abdominal pressure and make the varicocele more noticeable.
- Color Doppler Ultrasound: The doctor might order an ultrasound if a physical exam shows signs of a varicocele or if there are other issues. The veins in the testicles can be seen on an ultrasound, and their size and blood flow can be measured. Varicoceles are often checked with Doppler ultrasound, a type of ultrasound that shows how blood is moving.
Varicocele Treatment
If the varicocele does not affect fertility, there is no treatment required. Depending on the severity, healthcare providers or urologists may suggest the following options for varicocele treatment.
- Symptomatic Relief: If the varicocele is causing discomfort or pain, supportive measures can help alleviate symptoms. Not wearing tight underwear, applying ice packs (Not directly and for more than 15 minutes), and avoiding prolonged periods of standing can provide relief.
- Surgical Repair: Surgical intervention is a common treatment option for varicoceles, particularly when the condition is causing symptoms or affecting fertility. There are different surgical techniques available:
- Open Surgery: In this old procedure, a surgeon makes an incision in the lower abdomen or groin to access and ligate (tie off) the enlarged veins causing the varicocele.
- Laparoscopic Surgery: In laparoscopic surgery, to fix a varicocele, small cuts are made, and a thin, bendable camera guides the surgical tools called a laparoscope. This process causes less damage and recovers easily.
- Microscopic Surgery: is the latest technique, it has minimal complications and maximum benefits among all 2 options.
3. Embolization: An interventional radiologist does an embolization process, a minimally invasive procedure. A tube is put into the veins that need to be fixed, and then coils or a special solution are injected to stop the blood flow. This makes the veins smaller.
4. Fertility Treatment: If the varicocele is causing fertility issues, addressing the varicocele might improve sperm quality and increase the chances of successful conception.
