Varicocele is a condition seen in men, resulting from the enlargement of the veins around the testicles and the backward flow of blood in these veins. Although it is usually seen on the left side, it can rarely occur on the right side as well. Symptoms of varicocele include pain in the testicles, swelling, and varicose veins. Treatment options include embolization and sclerotherapy.
What is Varicocele?
Varicocele forms with the enlargement and coiling of the venous veins (pampiniform plexus) within the scrotum (testicular sac). This condition can develop similarly to the formation of varicose veins in the legs.
While veins carry blood from the testicles to the heart, blood can flow back due to malfunctioning valves, causing the veins to enlarge due to accumulation.
Varicocele is observed during adolescence and can progress over time. It is more commonly seen in the left testicle due to the anatomical structure of the vein on that side.
What are the Symptoms of Varicocele?
Varicocele can manifest with symptoms such as swelling in the scrotum, pain, and warmth in the testicles. Common symptoms of varicocele include:
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Pain or discomfort in the testicles, especially felt at the end of the day or after standing for a long time
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Swelling and a feeling of fullness detected in the scrotum
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Infertility over the long term
What Causes Varicocele?
Varicocele is a condition resulting from the enlargement of the venous network in the testicles and the backward flow of blood. It is more frequently seen in the left testicle, with causes including genetic predisposition and weakness of the vein walls.
Standing for long periods, lifting heavy objects, or factors that increase intra-abdominal pressure can also contribute to the development of varicocele. Although asymptomatic, some patients may experience testicular pain or infertility complaints.
Common causes of varicocele include:
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Structural abnormalities of the veins
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Backward flow of blood in the testicular veins
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Standing for long periods
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Engaging in heavy physical activities
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Genetic predisposition
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Enlargement of the blood vessels around the testis
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Hormonal imbalances
How is Varicocele Diagnosed?
Varicocele is usually detected during a physical examination. While the patient is standing, the doctor checks for swelling in the testicles and enlarged veins. The severity of the varicocele and irregularities in blood flow are also examined with imaging techniques like Doppler ultrasound.
Methods used for suspected varicocele include:
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Scrotal ultrasound
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Testicular volume measurement
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Thermography
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Semen analysis
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Venography
What are the Varicocele Treatment Methods?
Varicocele treatment methods vary and may include surgical and non-surgical options. Surgical treatment options include microsurgical varicocelectomy, laparoscopic varicocelectomy, and percutaneous embolization.
Non-surgical treatment options consist of medication, sclerotherapy, and non-interventional methods. The treatment method should be determined based on the patient's condition, the severity of symptoms, and the size of the varicocele. Therefore, after a detailed evaluation by a specialist doctor, determining the most appropriate treatment method is crucial.
How is Varicocele Surgery Performed?
Varicocele surgery (varicocelectomy) is a surgical method usually performed under local or general anesthesia to treat varicocele disease. The aim of the surgery is to ligate the enlarged veins and regulate blood flow.
During the surgery, a small incision is made in the groin area while the patient is under anesthesia. This incision is close to the area surrounding the testis with varicocele. After the incision, the enlarged veins are identified and either ligated or cut. Thus, blood flow improves, varicocele symptoms decrease, and sperm production may improve.
The incision is carefully closed, and the patient begins the recovery process once the effects of anesthesia wear off. A brief recovery period is experienced, and the patient can return to daily activities within a few weeks. Varicocele surgery is an effective treatment to resolve infertility and alleviate pain.
Recovery Process After Varicocele Surgery
The recovery process after a varicocele operation involves careful care and rest. For the first few weeks following the operation, physical activities should be avoided. Activities such as lifting weights, doing sports, or exercises that may stress the abdominal area are not recommended as they can disrupt recovery.
Scrotal supportive clothing reduces pressure on the surgical area and accelerates recovery. Supportive garments should be worn for several weeks and the duration should be adjusted according to the doctor's advice.
Frequently Asked Questions
Can varicocele heal on its own?
No, varicocele does not heal on its own. This condition occurs due to the malfunction of venous valves and can progress over time. While some patients do not show symptoms, others may experience problems such as testicular shrinkage, decreased sperm quality, and pain. Therefore, individuals showing symptoms or planning to have children need treatment evaluation.
Does varicocele cause infertility in every man?
No, varicocele does not cause infertility in every man. However, in medium and advanced cases, increased testicular temperature and decreased oxygen can affect sperm production. This can lead to a decrease in sperm count, reduced motility, and morphological abnormalities, contributing to male infertility. Sperm analysis provides information on this issue and guides treatment.
Does it recur after surgery?
The risk of recurrence after varicocele surgery varies depending on the surgical method used and the surgeon's experience. In advanced techniques such as microscopic varicocelectomy, this risk is quite low and generally around 1–2%. In more conventional surgical methods, the recurrence rate might be higher. Most patients achieve permanent recovery with a correctly performed surgery.
How is sexual life affected after varicocele surgery?
Post-surgery, there may be improvements in sexual function. The reduction of pain and increase in sperm quality may positively affect the sexual life of couples.