What is a Varicocele?
Varicocele, an enlargement of the veins within the scrotum due to leakage in valves, similar to varicose veins in legs. It occurs in about one in six males, more common in younger males, ages 15-30. It can be associated with infertility problems by contributing to low sperm production and decreased sperm quality.
Varicoceles are believed to be caused by defective valves in the veins within the scrotum, just above the testicles. Normally, these valves regulate the flow of blood to and from the testicles. When normal flow doesn’t occur, the blood backs up, causing the veins to dilate (enlarge). This most commonly takes place during puberty, when the testicles are experiencing rapid growth and need the most blood. In about 85 percent of cases, it occurs in the left testicle area. The poor circulation caused by the varicocele results in a higher blood temperature, raising the temperature of the testes, which can serve as a barrier to sperm production and damage or destroy sperm that is created.
In approx. 50% cases its asymptomatic or remain silent for longer period in initial stage. As disease progresses symptoms do occur, they tend to be felt as a dull ache or feeling of heaviness in the testicle, which gets worse during the day, particularly in hot weather or after physical exertion. The dilated veins in the scrotum can often be felt or seen, and the testicle is smaller on the varicocele side.
Physical Examination: Doctor examine testes in standing position.
Color Doppler Ultrasound (Rangeen sonography) : Test to detect varicocele and Grading.
Treatment for Varicocele
In early stage only conservative approach suffice like anti-inflammatory medications, wearing scrotal support and avoid heavy exercise.
In advance stage or if patient is symptomatic after conservative approach like having pain or infertility than definitive treatment required.
Surgical treatment is most practiced for the varicocele usually involves tying off the affected vein to redirect the blood flow toward normal veins. Surgery can be open, laparoscopic or microscopic. Later is recent one and allow exact identification of critical structures that need to be preserved during surgery, such as the testicular artery.
Varicocele embolization is latest and advance method to treat varicocele as it is minimally invasive procedure without any cut and done as Day care procedure. Patient can resume his daily work form very next day. In embolization anatomy of other vital structures like testicular artery, nerves and lymphatics are not disturbed at all.