Find Out Everything You Need to Know About Varicocele Today
A varicocele is a swelling of veins around the testicles caused by abnormal blood flow. It is often associated with infertility. This condition occurs as a result of blockage of the lymphatic system causing fluid buildup. In men, the lymphatic vessels are located near the spermatic cord where they collect and transport lymph (fluid). Lymph is then carried to the veins of the groin area and back toward the heart. If these vessels become blocked, the fluid builds up and causes swelling of the veins near the scrotum. Varicoceles occur in 10% of males between the ages of 15-35 years old.
A quick tip: In about 10% of cases varicoceles occur only after puberty, however, the majority of them arise before 20 years of age. Varicoceles are present in about 0.5-3% of men aged 15 to 40 years. However, they are relatively rare in patients younger than 15 years of age.
There are two types of varicoceles, congenital and acquired. Congenital varicoceles are present at birth and are not related to any specific disease. Acquired varicoceles tend to develop later in life. In some cases, the blockages in the lymphatic system can result in serious problems including infertility.
The varicocele is not cancer, however, if left untreated, it can cause damage to the testicle. There are several ways to treat a varicocele. Surgery is the most effective way to remove the varicocele. Surgical removal involves cutting open the scrotal skin and removing the varicocele. Sometimes, doctors recommend surgery after trying other treatments first.
Causes of a varicocele
There are many causes of a varicocele including congenital defects, injury, infection, inflammation, surgery, hormonal imbalances, and genetic disorders. Some people have a higher risk of developing a varicocele than others. Researchers believe this is due to genetic differences between individuals. In some cases, a varicocele may not cause any symptoms at all. However, if left untreated, the varicocele could lead to infertility.
How can you diagnose varicocele?
It is important to conduct a physical exam in order to determine whether there are symptoms present. A blood test can be performed to check hormone levels and the number of sperm in the body. Ultrasounds can sometimes detect varicocele. A CT scan or MRI can show whether the varicocele causes damage to the testicle. If you notice any type of problems related to the male reproductive organs, talk to your doctor about them.
Your doctor will examine the problem and perform some tests. Diagnosing varicocele requires a physical examination of the abdomen, scrotum, and testicular size. Scrotal ultrasound is a good method to evaluate if varicocele exists. An X-ray imaging or MRI scan can help to determine whether additional pathology may exist.
A study published in the Journal of Urology in 2017 looked at whether varicoceles could spontaneously resolve. Researchers examined data from 1,848 men who had been diagnosed with varicoceles between 2000 and 2016. Of those men, 836 were followed for two years after diagnosis. After two years, only 6% of the men still had varicoceles. Most of these men did not have any symptoms related to their varicoceles.
Varicocele: How do I know if I have one?
Varicoceles are often not noticed until they cause symptoms. Symptoms may include pain while having sex, difficulty getting an erection, low sperm count, infertility, and scrotal discomfort.
How does a varicocele affect my fertility?
If left untreated, a varicocele can lead to decreased semen quality and male infertility. In addition, men who suffer from a varicocele may experience lower testosterone levels than those without varicoceles.
What should I do?
If you suspect that you might have a varicocele, then visit a doctor immediately. Apart from medical treatment, exercise, and lifestyle changes may help reduce its occurrence.
Symptoms of a varicocele
Varicoceles cause pain, tenderness, and swelling around the testicles in the groin area. You might feel something hard in your scrotum, and your penis might look enlarged. Your doctor will check whether your testicles have dropped down into your abdomen, and he/she will examine them carefully.
It includes:
- Swelling of the veins in the groin area
- Painful intercourse
- Difficulty getting an erection
- Frequent urination
- Low sperm count
- Infertility
- Testicular atrophy
- Testicle shrinkage
- Erectile dysfunction
Treatments
Depending on how severe the condition is, there are a variety of treatment options. Your doctor may recommend surgery, medication, or lifestyle changes. Surgery involves ligation of the vein(s), which stops the blood flow causing swelling. Medication includes oral medications or injections to reduce inflammation and improve circulation. Lifestyle changes involve exercise and diet modifications.
Lifestyle Changes: Lifestyle changes are the first step toward treating a varicocele. These include exercise, eating healthier foods, avoiding alcohol consumption, reducing weight, etc. The body will produce less lymph fluid as a result of all of these lifestyle changes.
Medications: Varicocele symptoms commonly require medication, such as beta-blockers (e.g., propranolol). Beta-blockers work by relaxing muscles throughout the entire body including those surrounding the veins in the abdomen.
Surgery: The use of surgical procedures is limited to cases in which conservative measures fail to provide satisfactory results. An injection of a solution containing drugs into a vein is known as sclerotherapy. Once inside the vein, the chemicals destroy the lining of the vessel, forcing it to collapse and close off.
Injection therapy involves injecting a sclerosing agent into the pampiniform plexus of the spermatic cord. The sclerosing agent destroys the valves in the lymph vessels that carry lymph back to the venous circulation. As a result, lymph accumulates in the pampiniform venous plexus, resulting in swelling of the veins.
Injections of sclerosing agents into the pampiniform plexus are performed under local anesthesia. Most patients experience minimal side effects following injection therapy. Swelling, bruising, and tenderness at the site of the injections are normal reactions. Side effects may include fever and chills lasting several days following the procedure.
The success rate of injectable therapy varies among individual practitioners. Complication rates are generally low, although there are rare reports of serious adverse events. Patients who respond poorly to initial injections may benefit from repeat injections. Treatment failure may indicate coexisting pathology that requires additional evaluation.
Risks and Complications
There is a link between varicocele and infertility. Studies have shown that varicocelectomy improved semen quality and pregnancy rates in subfertile couples. Even couples with normal semen parameters who want to become parents should consider varicocele repair. Other factors influencing the decision to operate include age, size of varicocele, physical activity level, duration of symptoms, and the desire to avoid potential side effects of surgical intervention.
The bottom line,
There are no specific guidelines to avoid varicocele. However, avoiding pregnancy reduces the risk of developing varicocele. Most men with varicoceles don’t experience any problems. However, some people develop pain during intercourse or notice swelling around their testicles. Your doctor can help prevent complications by treating your varicocele at the first sign of varicocele symptoms. Treatment options include surgery or medication. Surgery involves cutting open the groin area and removing the vein. Medication includes taking certain drugs orally or injecting them directly into the affected vein.
