Varicocele is the medical name for the swelling and enlargement of the veins in the scrotum, or scrotum, which are loose skin bags that protect the testicles in men. Varicocele is similar to the “varicose vein” that can be seen in the legs, that is, varicose veins.
Cases occur in the upper part of the testicles, usually in the left testis. Individuals may not be able to see the varicocele while lying down, but it may become prominent enough to see the eyes when standing up. When touched by hand, the bag may feel as if there are plastic pipes or worms in it.
Varicocele is a fairly common medical condition and usually affects young men. This problem can be seen in 10 to 15 percent of men. Varicocele itself may not cause a medical problem, but if it does cause problems, it would be best to consult a urologist.
Varicoceles are a common cause of low sperm production and reduced sperm quality to amounts that can cause infertility. However, sperm production is not affected in all cases of varicocele. Varicocele can cause infertility as well as the testicles not developing normally or shrinking.
What Causes Varicocele?
Medical professionals have not yet reached a definitive conclusion as to why varicocele occurs. It is thought to be caused by a problem with blood flow in the spermatic cord, where blood flows to and from the testicles.
Experts have concluded that when the valves that control the flow in the veins in the spermatic cord prevent proper blood flow, the blood collects back and causes the veins to dilate.
This backward recruitment can both cause damage to the testicles and cause a decrease in male fertility.
Varicocele usually occurs in boys during puberty. Under normal conditions, it is observed that the left testis is located on the left testicular vein because it is lower than the right testis.
WHAT ARE THE SYMPTOMS OF VARICOCELE?
While 90 percent of varicocele cases are seen on the left testicular vein, 9 percent in both testicles, that is, bilaterally, the remaining few cases are diagnosed in the right testis. Lead to the development of varicocele
A varicocele usually does not cause any signs or symptoms except in its own form. Rarely, it can cause pain. Varicocele pain may range from mild discomfort to sharp pain, and may increase with prolonged standing and physical exertion.
There may be an increase in the level of pain felt from morning to evening. Individuals can relax by getting lighter when they lie on their back. In addition to pain, it can cause a decrease in male fertility.
Varicoceles may become more prominent over time. It is stated that in many cases it looks like a plastic pipe or a bag full of worms. It can cause swelling, almost always in the left testis.
However, asymptomatic varicoceles may generally go undetected if they are not detected during a fertility evaluation or a routine physical examination. However, individuals who experience pain or swelling in the scrotum, feel a mass in the scrotum, notice that their testicles are of different sizes, develop a varicocele in your youth, or have problems with conceiving a child should definitely consult a doctor. There are many medical conditions that cause scrotal masses or testicular pain, some of which require immediate treatment.
WHAT ARE THE COMPLICATIONS OF VARICOCELE?
There are two general complications that varicocele can cause apart from pain:
Shrinkage or atrophy of the affected testis. In human anatomy, most of the testicles consist of tubules that produce sperm. If the testicles are damaged due to the varicocele condition, they will shrink and begin to soften. Although the reasons behind this shrinkage are not fully known, it is suggested that blood accumulates in the vessels due to problematic valves, which increases the blood pressure in the vessels and causes the surrounding tissues to be exposed to toxins that can cause damage.
Infertility: Varicoceles can keep the local temperature in or around the testicle too high, affecting sperm formation, sperm movement, that is, motility, and preventing them from performing their functions.
HOW IS A VARICOCELE DIAGNOSED?
The doctor will perform a physical examination on the individual’s testicles, which can reveal any non-tender mass that feels like a bag of worms when touched.
If the varicocele mass is large enough, the individual or the doctor can easily feel this mass. However, if the mass is not large enough, the doctor may ask the individual to stand up, take a deep breath, close their mouth and nose and then try to force the breath out by pushing.
This is called the Valsalva maneuver and it helps to feel more enlarged veins than normal.
With the help of the Valsalva maneuver, varicocele is evaluated in three different degrees during the examination.
Grade 1: Varicocele in which no symptoms can be observed in the outpatient patient, but can be palpated during the Valsalva maneuver.
Grade 2: Varicocele, which is mildly observable in an outpatient patient and in which the veins become clearly visible as a result of the Valsalva maneuver.
Grade 3: Varicocele with clearly visible veins, although the outpatient patient has not started the Valsalva maneuver
If the physical examination is not sufficient, the doctor may order an ultrasound test of the scrotum, the scrotum. During the ultrasound test, sound waves are used to take pictures of the inside of the body.
This test is particularly useful for ruling out causes such as a varicocele or a tumor that may be causing the symptoms. It is especially helpful in determining how treatment should take place in young people.
METHODS OF TREATMENT
Varicocele treatment may not be necessary for every individual. Many men with varicocele can become fathers without any treatment. Although varicocele treatment usually leads to improvement in sperm quality, it is not yet clear whether an untreated varicocele causes sperm quality to worsen over time.
In the case of male infertility, varicocele treatment can improve infertility or improve sperm quality if techniques such as in vitro fertilization (IVF) are to be used. However, if the varicocele is painful, an operation to repair the varicocele may be considered, especially if it causes progressive testicular atrophy or abnormal sperm counts that progress through puberty.
HOW IS VARICOCELE SURGERY?
The purpose of varicocele operation is to compress or close the affected vein to redirect blood flow to normal veins.
Varicocelectomy, that is, varicocele surgery, is an open surgery performed in the hospital. This treatment is usually performed on an outpatient basis in a single day and under the influence of general or local anesthesia. The urologist who will perform the operation will usually approach the affected vessels from the inguinal region, that is, from the inguinal way or from the subinguinal way, but it is also possible to make an incision in the abdomen. The surgeon will then clamp or tie off the abnormal veins with the aid of a microscope. After this operation, blood flow is expected to occur around the abnormal vessels towards the normal ones.
LIFE AFTER VARICOCELE SURGERY
After the surgery, the doctor may recommend not to have sexual intercourse for a while. In the majority of cases, improvements in sperm quality can be seen with the help of semen analysis a few months after the surgery.
This is because it takes about three months for new sperm to develop.
Wearing tight underwear or a tank top to reduce blood pressure and prevent the veins from dilating can have a similar effect to compression stockings, helping to relieve pain or discomfort in some cases.
Nutrition has nothing to do with the formation or treatment of varicocele. Only individuals with chronic constipation can indirectly benefit from constipation-solving fiber or olive oil diets. It is not possible to treat varicocele with herbal or medicine.