Varicocele is a condition observed in men resulting from the enlargement of veins around the testicles and the backward flow of blood in these veins. Although it usually appears on the left side, it can rarely occur on the right side. Symptoms of varicocele include pain, swelling, and varicosity in the testicles. Treatment methods include options such as embolization and sclerotherapy.
What is Varicocele?
Varicocele occurs when the venous vessels (pampiniform plexus) inside the scrotum (testicle bag) enlarge and become tortuous. This condition can develop similarly to the formation of varicose veins in the legs.
While veins carry blood from the testicles to the heart, malfunctioning valves may cause blood to flow backward and accumulate, leading to their enlargement.
Varicocele is seen during adolescence and may 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 may appear with symptoms such as swelling, pain, and warmth in the testicles. Common symptoms of varicocele include:
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Pain or discomfort felt in the testicles, especially at the end of the day or after standing for long periods
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Noticeable swelling and a feeling of fullness in the scrotum
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Infertility in the long term
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Decrease in sperm quality
What Causes Varicocele?
Varicocele is a condition caused by 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 vessel walls.
Standing for long durations, heavy lifting, or factors that increase intra-abdominal pressure can also lead 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 prolonged periods
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Engaging in heavy physical activities
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Genetic predisposition
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Enlargement of blood vessels around the testicles
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Hormonal imbalances
How is Varicocele Diagnosed?
Varicocele is typically detected during a physical examination. The doctor examines the swelling and enlarged veins in the testicles while the patient is standing. The severity of the varicocele and irregularities in blood flow are also evaluated using imaging techniques such as 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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Doppler ultrasound
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Thermography
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Semen analysis
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Venography
What are the Treatment Methods for Varicocele?
Treatment methods for varicocele are diverse and can include both surgical and non-surgical options. Surgical treatment choices include microsurgical varicocelectomy, laparoscopic varicocelectomy, and percutaneous embolization.
Non-surgical treatment options consist of medication, sclerotherapy, and non-invasive methods. The treatment method should be determined based on the patient's condition, the severity of symptoms, and the size of the varicocele. Therefore, it is important to determine the most suitable treatment method after a detailed evaluation by a specialist doctor.
How is Varicocele Surgery Performed?
Varicocele surgery (varicocelectomy) is typically a surgical method performed under local or general anesthesia to treat the varicocele condition. The aim of the surgery is to tie off the enlarged veins and regulate blood flow.
During the surgery, a small incision is made in the groin area on the anesthetized patient. This incision is near the testicle affected by the varicocele. After the incision, the enlarged veins are identified and either tied or cut. This improves blood flow, reduces varicocele symptoms, and can improve sperm production.
After the incision is carefully closed, the patient begins the recovery process once the effects of anesthesia wear off. A short recovery period ensues, and the patient may return to daily activities within a few weeks. Varicocele surgery is an effective treatment for resolving infertility and alleviating pain.
Post-Surgery Recovery Process of Varicocele
The recovery process after varicocele surgery involves careful care and rest. Activities should be avoided for the first few weeks after the operation. Activities such as weight lifting, playing sports, or exercises that could put stress on the abdominal area are not recommended as they may interfere with healing.
Scrotal supportive garments reduce pressure on the surgical area and expedite healing. The duration of wearing the supports should be adjusted according to the doctor's recommendation and worn for several weeks.
Frequently Asked Questions
Does Varicocele heal on its own?
No, varicocele does not heal on its own. This condition arises due to the malfunction of vein valves and may progress over time. Some patients may not show symptoms, while others may experience testicular shrinkage, decreased sperm quality, and pain. Therefore, individuals who exhibit symptoms or plan to have children require a treatment evaluation.
Does Varicocele cause infertility in every man?
No, varicocele does not cause infertility in every man. However, in moderate to severe cases, increased testicular temperature and reduced oxygen may affect sperm production. This can lead to a decrease in sperm count, a reduction in motility, and morphological abnormalities, potentially contributing to male infertility. Sperm analysis provides information in this regard and guides treatment.
Does it recur after surgery?
The risk of recurrence after varicocele surgery depends on the surgical technique used and the surgeon's experience. With advanced techniques such as microscopic varicocelectomy, this risk is quite low and generally around 1-2%. In more traditional surgical methods, the recurrence rate may be higher. Most patients achieve permanent recovery after surgery with the right technique.
How is sexual life affected after varicocele surgery?
Improvement in sexual function may be observed after surgery. The reduction in pain and increase in sperm quality can positively impact the sexual life of couples.