A varicocele is an enlargement of the veins within the scrotum. These veins are called the pampiniform plexus.(“Bag Of Worms”)
They take blood from the testis back into the body.
A varicocele only occurs in the scrotum and is very similar to varicose veins that can occur in the leg.
Why Do These Veins Enlarge?
There is a problem with the valves that control the flow of blood from the testicles to the body.
As a result, blood tends to pool in the veins in the spermatic cord, the cord that runs from the testicle into the body.
The resulting backup causes the veins to widen (dilate).
When Does This Problem Start?
Varicoceles generally form during puberty and are more commonly found on the left side of your scrotum.
Is It A Rare Disease?
This is a fairly common problem worldwide.
They can be found in 15 percent of the adult male population and around 20 percent of adolescent males.
They’re more common in males aged 15 to 25.
So besides swelling any Harmful Effect?
1 Infertility It can cause infertility due to
- low sperm production
- decreased sperm quality.
Not all varicoceles affect sperm production.
2 Testicles to fail to develop normally or shrink.
How do I Know that I have varicocele? (Symptoms)
Usually, there are no symptoms initially
- a lump in one of your testicles
- swelling in your scrotum(Bag Of Worms)
- a dull, recurring pain in your scrotum
What Can I Do At Home To Treat Varicocele?
If you have mild symptoms you can try to.
- Avoid activities that causes the discomfort.
- Pain reliever such as ibuprofen or acetaminophen.
- Wearing a jockstrap during exercise or prolonged standing.
Do I Need To See A Doctor?
Indications to repair a varicocele
- Progressive testicular atrophy,
- Pain or
- Abnormal semen analysis results.
Why Is The Surgery Done?
The purpose of surgery is to
- Seal off the affected vein
- Redirect the blood flow into normal veins.
What Can I Expect After Surgery?
- If repaired in childhood or adolescence, the testicle may grow to “catch up” in size.
- treatment of a varicocele generally improves sperm characteristics
- might improve the quality of sperm if techniques such as in vitro fertilization (IV F) are to be used.
When surgery is done in adults the testis size does not increase to the normal size.
A. Open surgery. This treatment usually is
- Done on an outpatient basis,
- In general or local anesthesia.
- Inguinal or subinguinal – surgeon will approach the vein through your groin .
- Microsurgical Subinguinal Varicocelectomy.
- Open surgery using a microscope and subinguinal approach has the highest success rates when compared with other surgical methods.
- The use of the surgical microscope, has led to a reduction of post-surgical complications
B. Laparoscopic surgery.
- small incision in your abdomen and passes a tiny instrument through the incision to see and to repair the varicocele.
- This procedure requires general anesthesia.
C. Percutaneous embolization.
- The doctor releases coils or a solution into the veins that causes scarring to create a blockage in the testicular veins,
- This interrupts the blood flow and repairs the varicocele .
- This procedure isn’t as widely used as surgery.
How Fast Is The Recovery From The Surgery?
- Return to normal, nonstrenuous activities after two days
- More strenuous activity, such as exercising, after two weeks.
- Pain is mild but might continue for several days or weeks.
- Advise you not to have sex for a period of time.
How Much Time Does IT Take For Sperm Quality To Improve?
Most often, it will take several months after surgery.
It takes approximately three months for new sperm to develop.
Improvements in sperm quality can be seen with a semen analysis.
Side effects of surgery
Some of the potential side effects of outpatient surgery include the following:
- Surgical Site Infection – less than 1% of patients.
- Shrinking of the testicle – less than 1% of patients.
- Hydrocele – fluid around the testicle in less than 1% patients.
- Recurrence – less than 5% of patients.
- Failure to relieve pain – 15% of patients will have no relief, or inadequate relief, of pain
- Continued infertility – not all couples will benefit from surgery.
- Deep venous thrombosis (DVT) – less than 5% of patients
- Pulmonary embolus (PE) – less than 1%.
Precautions To Be Taken After Surgery
- Elevate the scrotum
Help relieve discomfort and minimize swelling.
This is especially helpful the first few days after surgery.
The scrotum is elevated enough if the testicles are at the same level as the front of the thighs.
- Scrotal support (a jock strap)
Minimize discomfort while you are standing, walking, or exercising.
- Pain reliever.
- Do not take baths or get the incision wet until the wound has healed, which should take about two weeks.
