Varicocele

Varicocele is defined as an enlargement of the veins within the loose bag of skin that holds your testicles, commonly the cause of low sperm production and decreased sperm quality.

Signs and Symptoms

Most of the men with varicocele are asymptomatic and many of them are detected through routine physical examination. Occasionally, the men with varicocele can present with pain on the testes which is usually on the left side and the patient may feel a dragging sensation. The presence of varicocele is damaging to the spermatogenesis by the reflux of high temperature, high waste metabolites venous blood, high pressure within the testes, and reflux of waste material from the kidney and adrenal metabolites. In the long run, it may have harmful effects on the testes, causing a decrease in the size of the testes and this may eventually cause a decrease in male hormones.

 

Risk Factors

The factors to consider prior to treatment of the varicocele will depend on the following:

  • Age of the patient and Grade of the varicocele
    The younger the patient is, the lower the grades of varicocele that will not require surgical treatment (provided the patient has no symptoms). The patient will only require conservative treatment of wearing tight underwear and not straining it so as to aggravate the varicocele. However, if it is grade is III and the patient sperm count is low, then surgical treatment may be necessary.

  • Symptoms of the varicocele
    If the patient has symptoms (pain or discomfort), especially relating to higher grades, then surgical treatment is necessary.

  • Effects of varicocele if not treated

The varicocele is due to back flow of venous blood from the renal vein into the testicular area. This will cause increasing testicular temperature and draining of toxic material from the kidneys into the testes. This will cause low sperm count and quality and atrophy of the testes and eventually cause early andropause. In these circumstances, surgical treatment is advised when the varicocele is grade II or III. When the loss of testicular volume is great, early legation of the varicocele may see greater benefits.

Treatment

The treatment is related to ligation and incision of the varicocele either at the inguinal area or retroperitoneal area. This can be achieved by the open method or laparoscopic method. Its complications are due to general anaesthesia and locally ligation include injury to the surrounding organs especially to the vas or testicular artery and this will cause atrophy of the testes and pain in some cases.

Disclaimer: This is not a guide to self-diagnose. We encourage to seek urologist advice further.

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