Varicocele, a vascular disease that occurs in men, means that blood flow is disrupted due to the expansion and elongation of the veins in the testicles. When blood flow is disrupted, blood begins to accumulate in the testicular area, which can lead to sexual reluctance and infertility . Varicocele symptoms include pain, sweating and a feeling of warmth in the area, but varicocele does not cause any symptoms, especially in the early stages. Varicocele is a vascular disease that progresses over time and occurs in an average of 15% of men.
What are the symptoms of varicocele?
The most prominent symptom in the advanced stages of varicocele is pain in that area. These pains, which can be felt from mild to moderate intensity, usually increase as a result of sitting or standing for long periods of time and the pains ease when the patient lies down. The pains may be felt more intensely at night, before going to bed, and may have disappeared when waking up in the morning.
The expansion of the veins can become noticeable enough to be noticed from the outside after a while, and the veins can take on a shape similar to varicose veins that occur in the legs. As the varicocele progresses, symptoms such as pain and swelling of the veins become more common. Varicocele can cause the testicles to shrink, but this symptom does not occur in every patient.
Why Does Varicocele Occur?
It is thought that varicocele occurs due to problems in the valves of the veins that carry blood towards and away from the testicles. However, there is no clear information about why these vein valves fail to function. When the vein valve does not function properly, the blood flow becomes irregular and the vein expands. Varicocele, which usually begins during puberty, occurs more often on the left side of the scrotum. However, even if varicocele affects only one testicle, it can cause a decrease in sperm production in both testicles.
Varicocele and Infertility
Varicocele is shown as one of the main causes of male infertility. Approximately 35% of men who apply to a doctor due to infertility have varicocele. Varicocele, which affects the testicles, also negatively affects sperm production and causes the sperm count to remain below the number needed to make a baby.
However, there are various opinions about whether the infertility caused by varicocele can be completely eliminated with varicocele surgery. While different experts state that pregnancy rates increase after varicocele surgery, according to various experts, varicocele surgery has no effect on pregnancy rates and this surgery should not be considered as a treatment for male infertility.
However, the fact that both sides accept is that sperm count and quality increase after varicocele surgery. An increase in sperm count occurs approximately 3 months after surgery. Scientific research and discussions on this subject are still ongoing.
How is Varicocele Diagnosed?
Varicocele diagnosis can usually be made through physical examination. If the doctor finds the physical examination insufficient for diagnosis, he/she may request an x-ray of the scrotum (scrotal).
Varicocele Treatment
The method to be applied in the treatment of varicocele may vary depending on the condition of the varicocele and the patient. If the varicocele does not cause any symptoms, no intervention is usually required. Supportive underwear can be used for mild symptoms. A specialist doctor may recommend annual check-ups for varicocele that occurs in healthy, young adult men.
Varicocele occurring during puberty can be treated by methods that can prevent the testicle from reaching its full size. At this stage, two different non-surgical techniques can be applied. The first is to prevent the growth of the dilated veins by binding them, and the other is to inject a specific chemical substance into the dilated veins (embolization), which means blocking these veins. Both techniques are highly effective treatment methods and the specialist doctor can guide the patient correctly about the advantages and disadvantages of these methods.
If varicocele pain continues regularly and other treatment techniques have not been successful, a surgical intervention method called “varicocele repair” can be used. This treatment method is mostly used as a solution to the infertility problem caused by varicocele. Local or general anesthesia can be applied during the varicocele operation. During the surgery, the problematic veins are cleaned and blood flow to these veins is prevented.
Varicocele surgery is included in the scope of “microsurgical” operations and the patient can usually go home within 4 hours after the surgery. Painkillers can be used for pain that may occur in the surgical area. It is recommended that the person stay away from heavy physical activities for 1-2 days following the surgery. The patient can start doing normal activities 7 days after the surgery.
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