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Varicocele: Symptoms, Causes, Diagnosis & Treatments

Testicles are held in a loose bag of skin and the enlargement of veins in the area is called varicocele. It appears similar to the varicose vein present in the leg. If you are suffering from varicocele, there will be an impact on the production of sperm. The reduction in sperm production and quality will have an impact on the reproduction. It can interfere with the normal development of the testicles and in some cases, it leads to the shrinkage of testicles.

In some cases, Varicocele may lead to complications. You should be aware of the symptoms so that you will get medical attention at the earliest. When you get the medical attention, you can prevent serious issues. You should be aware of the causes of Varicocele as well. If you are aware of the causes, you can take preventive steps so that further progression of the condition will be arrested.

 

Symptoms of Varicocele 

The development of varicocele will take over a period of time. Hence, you may not witness the symptoms immediately. Pain, swelling and difference in size of testicles are the predominant testicular symptoms. The medical professional can check these symptoms very easily.

  • Some patients suffer from pain. The pain will be either sharp or moderate.
  • The pain will increase with physical exertion (over a long period of time)
  • Will become worse during the day
  • There will be relief from pain when you lie down on the back
  • It will impact your fertility
  • The enlargement of varicoceles will take place over time. If the enlargement is abnormal, it will appear like a bag of worms.
  • The testicle will swell and the swelling will be prominent on the left side.
  • The testicle is made up of the sperm-producing tubules. If the testicle is damaged, it will become soft and small.

 

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Causes of Varicocele 

In the male reproductive system, the passage of blood will take place to and from the testicles and it takes place through the spermatic cord.

  • As per the opinion of experts, the formation of varicocele will take place due to the obstruction of blood flow by the valves in the cord. The veins will widen in this process. It might lead to the damage of the testicle and it will affect the reproduction system.
  • The formation of varicocele will take place in puberty. The varicocele will occur on the left (in most of the cases) due to the presence of the left testicular vein.
  • It will lead to grade I varicocele when the spermatic vein fills with the blood.
  • There will be damage to the spermatic vein and other veins when you suffer from a shunt type of Varicocele. It is considered as Grade II or III Varicocele.
  • If a patient suffers from Varicocele on one side, it will affect the sperm production on both sides.

 

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Diagnosis of Varicocele 

In most of the cases, the varicocele can be diagnosed very easily.

  • Physical examination is sufficient to diagnose the condition and it will be done by your doctor.
  • You will not find or feel varicocele when you are in lying condition. The examination of the condition will take place while you are standing up or lying down.
  • For some patients, a scrotal ultrasound test will be recommended by the doctor. The procedure will help to figure out the spermatic veins and the doctor will get a detailed picture of the condition.
  • There are three clinical grades in the varicocele. They are grade 1, grade 2 and grade 3. You should understand that the grade 1 is the smallest and the grade 3 is the largest.
  • The treatment is not based on the size but on the degree of comfort and the inconvenience caused due to infertility.
  • Sound waves of certain high frequency will be used to figure out the root issue associated with varicocele. The object identification and measurement of distances will be done very efficiently with ultrasound imaging technology.

 

Prevention of Varicocele 

The following preventive measures can be taken to overcome the Varicocele.

  • Avoid hot temperatures – The symptoms of Varicocele will worsen by being exposed to hot temperatures as it will lead to dilation of veins. Hence, you should avoid hot bath and exposure to hot temperatures. It will help you contain the pain in a very efficient manner.
  • Lifestyle – Healthy eating and fitness practices will enhance the fertility chances. If the patient is suffering from reduced sperm production, varicocelectomy or embolization will be performed.
  • Avoid lifting heavyweights – You should avoid lifting of heavyweights as there will be great pressure on the abdomen. Bodybuilding and weightlifting exercises should be avoided.

 

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Treatment of Varicocele 

There are no significant risk factors for the development of varicocele. If you are going through the assisted reproductive methods, you should undergo the treatment.

  • Varicocele does not require treatment in many cases.
  • If there are symptoms in the patient, the condition can be corrected surgically.

The following conditions warrant the treatment of varicocele:

  • Causes pain
  • Leads to infertility
  • Leads to testicular atrophy
  • Varicocele will alter the functioning of testicles. Hence, you will want to go for the most appropriate treatment. The sperm production will improve if you take the treatment at the earliest.
  • To overcome the pain, you might want to wear tight underwear or a jock strap. With the firm support offered by the underwear, there will be a great comfort.
  • The other forms of treatment include varicocelectomy and varicocele embolization. These procedures are chosen when the suffering of the patient is severe.
  • Varicocelectomy procedure can be performed on out-patient mode. The abnormal veins will be tied by entering through the abdomen or pelvis. In this process, the blood flow will take place to the normal veins. You should want to talk to your doctor about the procedure so that the precautions, as well as aftercare measures, can be followed.
  • Varicocele embolization is a procedure which is performed on the same day. The less-invasive procedure will be done by inserting a small catheter through the groin or nerve vein. A coil will be placed in the catheter and into the varicocele. Thus, the blood that oozes out to the abnormal veins will be blocked.
  • After the surgery, you can attend the work in one or two days. However, you should not do exercise for at least 2 weeks.
  • If you undergo the embolization, the recovery will be quick.
  • If there is a change in size, shape and appearance of testes, you should consult the physician.

 

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Management of varicoceles through non-surgical methods

The non-surgical treatment of Varicocele is an effective means to manage the condition. There will be a great relief from discomfort and pain with the non-surgical treatment.

  • Anti-inflammatory non-steroidal treatment – There will be symptomatic relief from pain by using non-steroidal anti-inflammatory medication. However, you will treat the symptoms and it is not considered a specific treatment. If there is severe pain, the surgical repair of a varicocele will be the only option.
  • If the patients wait for the surgery, painkilling medication can be used. If you are using painkillers such as aspirin, you should want to inform the doctor about the same. The painkillers will bear a risk of prevention of blood clotting ability.
  • There will be relief from pain by lying down on the bed. However, there will be temporary relief from pain. If there is severe pain, the surgery is the highly recommended option.

 

Complications of Varicocele 

You should visit the doctor in the following circumstances:

  • Pain or swelling in the scrotum
  • Presence of mass on the scrotum
  • The testicles are of different sizes
  • The development of varicocele during the youth
  • Having issues with the fertility
  • The shrinkage of the affected testicle is called atrophy. The testicle is made up of sperm-producing tubules. The testicle will shrink and damage due to the formation of a varicocele.
  • The exact reason for the shrinkage of the testicle is not yet ascertained by doctors. However, due to the malfunction of the valve, the blood will pool in the veins. It will lead to enhanced pressure in the veins and with enhanced exposure to toxins from the blood, the testicles will be damaged.
  • The local temperature around the testicles will be high when you are affected by varicocele. It will have a direct influence on the sperm formation, motility and function.
  • It may lead to primary infertility in 35% to 44% of men if the couple fails to produce the child after one year of trying.
  • It may lead to secondary infertility in 45% to 81% of men if the couple manages to produce the child at least once but not later.
  • If you fail to treat the varicocele, there will be a decrease in the sperm quality and quantity. It will lead to infertility and the prolongation of the issue on a long-term basis will lead to testicular injury which cannot be reversed.
  • The low level of testosterone will lead to many issues such as the inability to get a firm erection, low sex drive, fatigue, depression, lack of focus, hot flashes, decreased muscle mass, difficulty sleeping.
  • Varicocele may lead to hormone imbalance. The cells will react if there is an increase in pressure and it can lead to a change in hormones. Luteinizing hormone (LH) is present in both men and women. However, it may increase is men due to Varicocele. The testosterone levels will be normal to sub-normal.
  • Bleeding into tissues which is also called as hematoma is one of the common complications associated with Varicocele.
  • Some men will suffer from the accumulation of fluid around the testicle which is affected by Varicocele.
  • The possible other kinds of complications are infection and injury to scrotal tissues or structures. If there is an injury to the testicle, it will lead to loss of testicle as well.

     

Myths about Varicocele 

Myth #1: It is difficult to live with varicocele

Varicocele is a common complication in males. You can consult your doctor to get an appointment with the specialist. The reproductive specialist will help you and your partner in getting the children.

 

Myth #2:  Surgery cannot be performed to obtain children

Surgery is the option to get children. If you are suffering from severe pain, the doctor will suggest the most appropriate surgery so that you will overcome the pain and there will be a great scope to produce children as well.

 

Myth #3:  Varicocele is similar to varicose veins

Even though varicocele is similar to varicose veins, it occurs around the legs. Even though there are no serious issues with the varicocele, it will affect the reproductive system.

 

Myth #4:  Varicocele affects both sides

Varicocele generally affects the left side.

 

Myth #5:  Tests are not mandatory for Varicocele treatment

Urologists will conduct various tests to figure out the Varicocele’s impact on fertility. By conducting ultrasound tests, blood tests and semen analysis, it is possible to diagnose the case.

 

Myth #6:  Most of the men who are infertile suffer from Varicocele

It is only reported in around 15% of men. It was also observed that 35% of the men who were tested for infertility suffer from Varicocele. Hence, 80% of men have issues which are not related to the Varicocele.

 

Myth #7 Varicocele surgery will improve male fertility

It is not proven whether varicocele surgery can improve the male fertility due to lack of clinical data.

 

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Conclusion

Varicocele is similar to varicose veins. However, it will affect the testicular area in men and it may have a negative impact on the reproduction system. About 15% of men between the age of 15 and 25 years suffer from Varicocele. Even though the exact cause for Varicocele is not known, it will be similar to varicose veins. You will not want to suffer from varicose veins as it is not a serious issue. However, you should undergo the treatment to overcome the fertility issues. If there are severe complications, you should undergo the surgery.

 

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Last updated on : 24-12-2018
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