A varicocele is a condition that affects the veins in the scrotum, the pouch of skin that holds the testicles. Similar to varicose veins in the legs, it occurs when the veins become enlarged and twisted. A varicocele can cause pain, swelling, shrinkage of the testicles, and infertility. We will discuss the causes, symptoms, diagnosis, treatment, and prevention of varicocele in this blog post.
The exact cause of varicocele is unknown, but it may be related to the anatomy of the veins in the scrotum. Spermatic veins drain blood from the testicles. They form a network called the pampiniform plexus, which connects to the larger veins in the abdomen. In addition to carrying blood from the kidneys and other organs, the left spermatic vein joins the left renal vein, while the right spermatic vein joins the right renal vein.
Blood pooling and pressure may be more common in the left spermatic vein because of its sharper angle than the right. A varicocele is caused by the enlargement and twisting of the veins that result from this malfunctioning valve, allowing blood to flow backward and accumulate in the pampiniform plexus. Varicoceles can also occur on the right side or both sides, but this is less common.
A varicocele may not cause any symptoms in some people. They may only discover it during a physical exam or a fertility test. However, some people may experience the following symptoms:
A lump or swelling in the scrotum, usually on the left side
A feeling of heaviness or dragging in the scrotum
A dull ache or pain in the testicle, scrotum, or groin, which may worsen with standing, sitting, or physical activity
A decrease in the size or firmness of the testicle, especially on the affected side
A reduced sperm count or quality, which may lead to infertility
A varicocele can be diagnosed by a physical examination and imaging tests. During a physical exam, the doctor will feel the scrotum for abnormal veins, especially when the person stands or bears down. In addition, the doctor may ask about a person's medical history, symptoms, and fertility status.
Imaging tests, such as ultrasound or color Doppler, can confirm the diagnosis and rule out other conditions that may cause similar symptoms, such as tumors, infections, or hernias. In ultrasound, sound waves are used to create images of internal structures. Color Doppler ultrasound shows blood flow in the veins, so it can be used to measure the size, shape, and function of the testicles as well as the veins.
A varicocele may not require any treatment if it does not cause any symptoms or affect fertility. However, if it causes pain, discomfort, testicular atrophy, or infertility, surgery or a minimally invasive procedure can be used to treat it. In this treatment, blood flow to the abnormal veins is blocked and redirected to normal veins.
Varicocelectomy is the surgical procedure for removing varicocele. It can be performed by open, laparoscopic, or microsurgical means. The surgeon will make a small incision in the groin or abdomen, tie off, or remove the affected veins. General or local anesthesia is usually used, and the procedure usually takes about an hour. A person may need to stay in the hospital for a few days and avoid strenuous activities.
An interventional radiologist, a doctor who specializes in using imaging techniques to guide catheters and other devices inside the body, can perform a minimally invasive procedure called varicocele embolization, which is a minimally invasive procedure for varicocele. As soon as the doctor inserts a catheter into a vein in your groin or neck, he or she will inject a coil or liquid to block the blood flow to your varicocele. Local anesthesia is usually used for the procedure, which takes about an hour. The patient can return home the same day and resume normal activities a few days later.
In most cases, surgery or embolization eliminates or reduces the varicocele, with a success rate of 80% to 90%. It is rare for complications to occur, but they may include infection, bleeding, injury to nearby structures, recurrence of varicocele, or loss of blood supply to the testicle. In addition to following the doctor's instructions, the patient should report any symptoms, including fever, swelling, redness, or severe pain, to the doctor.
As varicocele is largely determined by the anatomy of the veins, there is no way to prevent it. However, there are some factors that may increase the risk of varicocele or worsen its symptoms:
Obesity, which can put extra pressure on the veins
Constipation, which can strain the abdominal muscles and veins
Heavy lifting or exercise, which can increase the blood flow and pressure in the veins
Smoking, which can damage the blood vessels and impair blood circulation
The risk or severity of varicocele may be reduced by maintaining a healthy weight, eating a high-fiber diet, avoiding excessive strain, and quitting smoking.
