Varicocele

What is a varicocele?

A varicocele (VAIR-ick-oh-seal) is a common condition characterized by enlarged veins in the scrotum. Your scrotum is a pouch of skin behind your penis that usually houses your testes (testicles). Varicoceles look similar to varicose veins. Varicose veins cause the veins in your legs to enlarge and lose form.

Varicoceles are normally painless, however they might cause intermittent testicular discomfort. In certain cases, a varicocele may induce infertility. If your varicocele does not affect you, you may not need treatment.

Is a varicocele serious?

Varicoceles are not life threatening. However, a varicocele may be very dangerous if you are attempting to conceive a biological kid.

Can varicoceles impair fertility?

Yes, varicoceles may impair fertility. Varicoceles may account for around 40% of all occurrences of male infertility. However, many individuals with varicoceles are able to conceive successfully.

Medical professionals don’t know what function varicoceles play in infertility. The temperature within your scrotum may rise as blood accumulates in the veins. Higher temperatures in both testicles may impact sperm count or production.

If you believe you are infertile, see a healthcare practitioner. The primary reason individuals seek varicocele therapy is to address fertility difficulties.

How prevalent are varicoceles?

Varicoceles afflict 15% to 20% of all males. A varicocele is more likely to develop on the left side of your scrotum due to changes in how blood drains from your left testicle into the body’s main veins. It may occur on either the right or left side, less often.

Symptoms & Causes

What symptoms indicate a varicocele?

Varicoceles normally do not cause any symptoms. However, you could notice:

• Dull testicular discomfort or hurting in your scrotum that generally resolves when you lay down.
• Swelling in the testicles or scrotum.
• Your testicles are shrinking (testicular atrophy).
• Infertility refers to the inability to get pregnant after at least a year of trying.
• A tiny bump above the damaged testicle.

How does a varicocele feel like?

Larger varicoceles may feel or resemble a sack of worms or spaghetti. They might produce minor discomfort, aches, or pains. Smaller varicoceles may be too small to detect or feel.

What is the primary cause of a varicocele?

Healthcare practitioners and medical specialists are unsure what causes varicoceles to form. Some believe they are caused by a defective “switch” (valve) within certain veins in the spermatic cord. The spermatic cord is a ring of tissues that keeps your testicles in place. These veins transport blood from the testicles to the body. The valve functions as a kind of “on/off” switch. It features two flap-like structures that let blood flow back to your heart. When a valve fails to function properly, blood may accumulate within the veins of your testicles. Veins enlarge with time.

Who does varicoceles affect?

Anyone with testicles, regardless of age, may develop varicoceles. Healthcare practitioners think that many varicoceles are present at birth (congenital). Varicoceles are often seen in teenagers. Medical experts believe this is related to puberty, which increases blood flow to the genitals. In rare situations, a varicocele might prevent your testicle from developing normally.

Do varicoceles induce erectile dysfunction?

There isn’t enough evidence to conclude that varicoceles cause erectile dysfunction (ED), although there might be a correlation. According to certain research, those who get varicocele therapy may still fail to achieve an erection on occasion, albeit less often.

Are there any additional problems from a varicocele?

Larger varicoceles may raise the risk of additional problems, including as

• Male hypogonadism is characterized by low testosterone levels. Males produce testosterone in their testicles. Testosterone is a hormone that promotes masculine features throughout puberty, increases libido (sex desire), and strengthens bones and muscles. Low testosterone levels may shrink your testicles, lower your sexual desire, lessen your muscular mass, and induce sadness.
• Azoospermia. Azoospermia occurs when your ejaculate (semen) contains no sperm. Sperm cells are reproductive cells that fertilize egg cells (ovums or oocytes). This produces an embryo, which eventually grows into a fetus. Azoospermia is a cause of male infertility.

Diagnoses and Tests

How is a varicocele diagnosed?

A varicocele may be diagnosed by a healthcare practitioner. They will evaluate your medical history, inquire about your symptoms, and do a physical examination.

During the physical examination, your provider may instruct you to stand up, take a deep breath, shut your nostrils and mouth, and work to expel air. This is the Valsalva maneuver. They will examine your scrotum for swollen veins while you are holding your breath and straining.

They might potentially request the following tests to validate their diagnosis:

• Pelvic ultrasonography. A pelvic ultrasound is a noninvasive imaging procedure that provides your doctor with a thorough look of the veins in your testicles. It is the most frequent imaging test ordered by physicians to diagnose varicoceles.
• Semen analysis. During a semen analysis, you will masturbate into a specialized container. Your physician will next send your sperm sample to a laboratory, where technicians will examine the presence and general health of the sperm. If your physician suspects a varicocele is interfering with your fertility, he or she will conduct a semen analysis.
• A blood test. During a blood test, your clinician will extract a little amount of blood using a tiny needle. Your blood sample will be sent to a lab, where experts will test for hormone levels such as follicle-stimulating hormone (FSH) and testosterone.

After establishing the existence of a varicocele, your clinician will determine its severity.

What are the different degrees of varicocele?

Healthcare practitioners utilize grades to identify and rate varicoceles.

• Grade 0 – This is the smallest form of varicoceles. Your doctor cannot feel it during a physical checkup, but they can see it using an ultrasound.
• Grade I – Your provider cannot see the varicocele and can only feel it when you do the Valsalva technique.
• Grade II – Your provider can feel the varicocele even when you are not using the Valsalva maneuver, but it is not visible.
• Grade III – This is the biggest varicocele. Your provider can see and feel it.

Management & Treatment

How do you remove a varicocele?

• Treatment for varicocele is determined on its severity. A healthcare physician may prescribe at-home treatments for low-grade varicoceles, such as:
• There is no therapy. If your varicocele causes no discomfort or reproductive problems, you may not need treatment.
• Make changes to your regular routine. You may need to avoid activities that make you uncomfortable. Wearing tighter-fitting underwear (such as spandex or elastane) or a jockstrap when exercising or standing for extended periods of time might help alleviate discomfort.
• Ice. Applying ice or cold packs to your scrotum might help reduce pain and discomfort. Do not apply ice straight to your skin. Wrap an ice or cold pack in a towel. Apply ice for no longer than 15 minutes at a time.
• Over-the-counter (OTC) drugs. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as naproxen and ibuprofen, may help reduce scrotal or testicular aches and pains. Because not everyone can use NSAIDs, it’s best to consult with a doctor before using them.

What is varicocele surgery?

A varicocelectomy is a surgical technique used to treat severe varicoceles that cause discomfort or interfere with conception. A surgeon who specializes in diseases affecting the urinary and reproductive systems will cut your problematic veins and seal their ends. This shifts blood flow to other healthy veins in the scrotum.

How long does it take to recover after varicocele treatment?

Most patients recover completely from a varicocelectomy within six weeks.

What happens if a varicocele is untreated?

• It is determined by the varicocele grade. If you have a minor varicocele that does not irritate you or interfere with your fertility, your doctor may not prescribe treatment.
• If you have a higher-grade varicocele and do not seek treatment, it might permanently harm your testicles.

Prevention

Can a varicocele be prevented?

Medical specialists are unsure what causes varicoceles to form. As a consequence, they are unsure how to prevent them.