Varicocele

Overview

In simple words, varicoceles are enlarged veins. These can occur in the scrotum too. It presents as swelling or an enlargement above the testicle but without any discolouration. This affects a group of veins in the scrotum called the pampiniform plexus. The function of these veins is to cool the blood before it travels to the testicles. If the testicles get too hot, the sperms in them can become damaged. Blood that is cooler than the body temperature helps keep the fertility intact. Varicoceles do not often cause discomfort or symptoms except for swelling but can cause fertility issues.

Not all men with varicoceles experience infertility. But it is to be noted that infertility is higher in men with varicoceles than in men without them. Some studies show that treating varicoceles can improve fertility. The chances are that varicoceles may affect the sperm count and may damage them. If the semen analysis is normal, varicoceles may not have an effect on the person’s fertility.

Causes and risk factors

Doctors do not know why varicocele is formed. But it is thought that the valve that stops blood from flowing back in veins gets damaged, causing varicoceles. The risk factors are

  • Smoking
  • Growth in stomach
  • Age over 45
Diagnosis

A fertility expert can diagnose varicoceles through a thorough physical exam in which he feels the scrotum for lumps or blood vessel abnormality. If a varicocele is suspected, the expert will ask you to get an ultrasound scan to confirm the diagnosis. Semen analysis may also have to be done if the person has fertility problems.

Treatment

Varicoceles do not need treatment unless the person has a low sperm count and other sperm related problems, has pain or has unexplained infertility. The options of treatment are the following-

  • Embolization
    This is a surgery in which the blood supply is temporarily cut off to block the varicocele.
  • Surgery
    The doctor can remove the varicocele after blocking the flow of blood to the vein. This is called varicocelectomy. It can be done by both open surgery and
    laparoscopic surgery. The latter uses a small incision and has a smaller recovery period.

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