A varicocele is the enlargement of the veins within the scrotum. This is very similar to varicose veins in the legs. Varicoceles are a frequent cause of infertility in men due to the affectation in sperm production.
About 15% of men have some degree of varicocele; the side most frequently affected is the left.
Causes and risk factors
- Varicoceles arise from the absence or incompetence of venous valves in the pampiniform plexus of the scrotum; They usually appear in adolescence and young adulthood.
- The following risk factors have been identified:
- Having direct relatives with varicocele
- Rapid testicular growth (adolescence)
- Tall and slim body build
- Having varicose veins in other parts of the body (hemorrhoids, varicose veins in the legs, etc.)
- Sometimes, the varicocele is due to a compression of the spermatic vein in the inguinal or abdominal region; may be secondary to:
- Inguinal Hernia Repair
- Spermatic vein thrombosis
- Extrinsic compression of the spermatic vein by the superior mesenteric artery
- Abdominal tumor (rarely)
Symptoms
Varicocele can generate the following findings:
- Moderate to severe testicular pain that may radiate to the leg on the affected side
- Heavy sensation in the affected testicle
- Testicular atrophy when it appears in adolescence
- Poor semen quality (low count, poor motility, and excess abnormal sperm)
Diagnosis
The diagnosis of varicocele is based on a complete history and physical examination. To complement the diagnosis it is recommended to do:
- Testicular and inguinal ultrasound in search of hernias
- Semen analysis
- FSH blood levels
- Tomography (CT-scan) or abdominal MRI in case of suspicion of an abdominal or retroperitoneal tumor as the cause of the varicocele
Treatment
The goal of treatment is to relieve pain and improve semen quality.
- Anti-inflammatory pain relievers
- Scrotal elevation
- Local ice
- Surgical repair (this is the ideal treatment)
Indications for performing a varicocelectomy
- Symptomatic varicocele (pain)
- Infertility due to varicocele
- Desire to preserve fertility in adolescents
Benefits of reversing vasectomy
Surgical treatment is more than 90% effective in eliminating varicoceles.
The purpose of surgically removing a varicocele is to relieve testicular pain, prevent testicular atrophy, and improve semen quality.
When there is a varicocele, the temperature of the testicle is slightly above normal; By removing the varicocele, the testicle recovers its normal temperature and allows it to function properly.
By performing a varicocelectomy, fertility can be recovered and a pregnancy achieved.
Varicocelectomy is considered a minimally invasive surgery that offers a rapid recovery and little postoperative pain.
