When the veins in the region of the testicle enlarge, it is referred to as a varicocele.
In other words, it is basically a varicose vein in the area of the testicle. Some varicoceles cause symptoms and require treatment. Varicoceles can affect sperm production and are an important cause of male infertility. Varicoceles are most common in males aged 15 to 25 years – it is fairly uncommon for an older man to develop a varicocele.
Causes:
A varicocele is the result of dysfunction of the veins which drain blood from the scrotum. Normal veins have valves that prevent the backflow of blood towards the scrotum. In a patient with a varicocele, dysfunction of these valves leads to inadequate drainage of blood from the testicular veins. In very rare circumstances, the backflow of blood in the testicular veins may be a result of a tumor in the abdomen compressing the veins. This rare type of varicocele (caused by tumor) is mostly seen in older men.
Varicoceles occur mostly on the left side
What tests can be done to diagnose a varicocele?
Clinical examination:
Most varicoceles are diagnosed on clinical examination: your scrotum and the surrounding structures will be examined by your doctor. Not all varicoceles are easy to pick up in this way.
Ultrasound:
An ultrasound scan of the scrotum can be done to confirm the presence of a varicocele. Ultrasound is also useful to pick up a possible tumor in the abdomen of an older man who develops a varicocele.
Semen analysis:
This can be done to assess the quality and number of sperm produced by the testicles. Because varicoceles can cause infertility, a semen analysis is useful in a man with a varicocele and fertility problems.
Complications of a varicoceles:
- Male infertility and poor sperm quality.
- Pain and discomfort in the scrotum and testicles.
- A decrease in the size of one or both testicles.
Treatment options:
1. Conservative management:
Some varicoceles do not require any specific treatment. For men who have only mild discomfort from time to time, tight fitting underpants can give scrotal support and prevent the discomfort associated with the engorgement of the enlarged testicular veins.
2. Varicocele surgery:
Surgery is needed in cases where the varicocele causes infertility or other complications (persistent pain, sperm abnormalities, shrinkage of the testicle). There are various surgical options for dealing with a varicocele: Varicocelectomy involves tying off the veins that are enlarged to prevent the backflow of blood into the scrotum. This can be done via keyhole surgery (laparoscopic) or microsurgically.
Microsurgical varicocelectomy has the highest success rate and lowest recurrence rate and no overnight stay in the hospital is required after this procedure.