Varicocele refers to the abnormal dilation and enlargement of the veins in your scrotum. Similar to a varicose vein that you might notice in your leg, varicoceles usually show up above one of your testicles (often the left one).

The science behind the causes of this condition is still unclear, but experts believe it could develop when the valves inside the spermatic cord prevent your blood from flowing properly. To understand this condition better, let’s take a closer look at the warning signs:

Symptoms 

Varicoceles seldom cause pain, and you may have no symptoms linked to the condition. However, in some cases, it has been described as a ‘bag of worms’ if the varicocele is large enough. A few others are below: 

  1. One sign of varicocele is testicular pain that switches from dull to sharp during the course of the day or when you exert yourself for long durations.
  2. You can also consider it a symptom if you feel immense relief while lying down on your back.
  3. Since varicoceles can lead to a decreased sperm count, therefore fertility becomes an issue for men who have this condition. Please do check this with your doctor while getting a physical exam.

Diagnosis

Varicoceles are usually asymptomatic. They are often found in the course of an infertility workup, although large varicoceles are easily identified upon a simple inspection.

During a physical check-up, your doctor will diagnose the condition after examining your testicles. It is important to note that varicoceles can’t always be seen while lying down. Hence, the doctor may ask you to take a deep breath while standing up and hold it while you bear down.

In some cases, the doctor may need to perform a scrotal ultrasound to get an accurate conclusion. Thermal imaging may also be used to confirm the possibility of varicocele.

Treatment

Seeking treatment for the condition can depend on whether you have the symptoms or whether you are trying to conceive. Treatment for varicocele might not be completely necessary. Quite often, men who are diagnosed with this condition are able to have children quite easily.

Having said that, you may want to consider treatment in case of pain, abnormal growth of testicles or infertility over a prolonged period. The main goal of varicocele treatment is to stop the build-up of blood, and it is best to take your doctor’s advice while deciding on a further course of treatment.

There are three repair methods to treat this condition:

  1. Open surgery: Generally done as an outpatient procedure, the doctor will either numb the area or administer general anaesthesia as a part of this procedure. When treated surgically, the varicocele is repaired through a single 1-inch cut into the scrotum.
  1. Laparoscopic surgery: Performed under general anaesthesia, this surgery involves a much smaller incision used to insert thin tubes and a special camera that helps the doctor see inside your body and operate on the varicocele.
  1. Percutaneous embolization: This procedure is done by a radiologist who inserts a special tube into a vein either in the groin or neck. He then uses an x-ray to examine the enlarged veins. This is followed by releasing a coil or balloon that creates a blockage in the testicular veins, leading to an interrupted blood flow thereby repairing the varicocele.

Risk Factors

Varicocele treatments can present some rare risks. These are outlined below: 

  • Persistence or reoccurrence of varicoceles
  • Infection
  • Fluid build-up in the testicles
  • Injury to the testicular artery

Healing after surgery is usually quick and painless thanks to the minimally invasive procedures. However, it’s best to relax and keep a light schedule following the treatment in order to avoid any pain or discomfort. Keep in touch with your physician and take note of any symptoms you notice before or after visiting your doctor. 

Complication 

  • Shrinkage of the affected testicle (atrophy). The bulk of the testicle comprises sperm-producing tubules. When damaged, as from varicocele, the testicle shrinks and softens. It’s not clear what causes the testicle to shrink, but the malfunctioning valves allow blood to pool in the veins, which can result in increased pressure in the veins and exposure to toxins in the blood that may cause testicular damage.
  • Infertility. Varicoceles might keep the local temperature in or around the testicle too high, affecting sperm formation, movement (motility) and function.

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