A varicocele is an enlargement of the veins in the scrotum, that’s the bag that contains the testes. This occurs when the pampiniform plexus vein is affected. The pampiniform plexus is responsible for cooling the arterial blood before it reaches the sperm. It does this through a “heat exchange” mechanism.
Varicocele is very similar to varicose veins of the leg. They happen when certain veins in the scrotum become enlarged, due to a malfunction in some of the valves involved in pumping the blood. Varicoceles normally affect just one side, usually the left.
Causes of Varicocele
Studies have it that a varicocele forms when the valves inside the veins in the cord prevent your blood from flowing properly. The resulting backup causes the veins to widen.
Faulty valves can disrupt the blood flow. The blood pools rather than moving smoothly on. This build-up of blood causes the vessels to dilate.
Types of Varicocele
Varicoceles can be classified as:
Pressure type: The spermatic vein fills up with blood, giving rise to a grade I varicocele.
Shunt type: A severe buildup causes damage to the spermatic vein and other veins, leading to a larger, grade II or III varicocele.
The left testicle is most likely to be affected. However, even if only one side contains a varicocele, this can impact sperm production on both sides.
Symptoms of Varicocele
Varicoceles in most cases is not featured with pain. Actually, the physician may notice them during a medical examination.
But, should any of the following listed here is noticed by the individual, it is very important to reach out to your doctor. They are:
- any change in the size, shape, or appearance of the testes
- a lump
- swelling in the scrotum
- veins that show as unusually large or twisted.
How to Diagnose Varicocele
There are three grades of varicocele:
- Grade 1: The smallest type, this is not visible, but a physician can feel it if they use a Valsalva maneuver.
- Grade 2: This is not visible, but it can be felt without a Valsalva maneuver.
- Grade 3: The varicocele is visible.
If the growth is large enough, it may feel something like a soft “bag of worms.
A subclinical varicocele is a varicocele that can only be detected through imaging tests. This could be scrotal thermography or a Doppler reflux test, a type of ultrasound.
An ultrasound test will also help to rule out other possible causes of the varicocele, such as a tumor on or near the spermatic vein.
Other possible tests include a semen analysis and hormone tests to detect high follicle-stimulating hormone (FSH) and low testosterone. These may be done if the doctor suspects a testicular dysfunction.
A varicocele does not usually pose a risk, but if there is any change in shape, size, or consistency in the genital region, it is important to see a doctor.
Treatment options for Varicocele
As earlier stated, varicoceles is not a life-threatening disease and can disappear on its own, Therefore, treatment may not be needed as such, only if is associated with pain and the issue has lingered for more than 1 year. If the state of the condition is bad, then some methods would be recommended. One is Surgery surgery may be recommended.
The surgery can be done in three ways. Namely:
Varicocelectomy: Open surgery is performed under local or general anesthetic. The surgeon will access the area through the groin, or less commonly, through the abdomen or upper thigh. Using ultrasound and surgical microscopes, they will close the affected veins to reroute the blood through other, healthier vessels.
Laparoscopic surgery: The surgeon makes a small incision in the abdomen and passes a tiny surgical instrument through the opening.
Percutaneous embolization: A radiologist inserts a tube, or catheter, into the body through the neck or groin. Instruments are passed through the tube, and the surgeon uses coils or chemicals to block the vein by scarring it. This is a minimally invasive intervention. It can be done as an outpatient procedure, and recovery time is relatively short.
Risks associated with surgery
These procedures are relatively safe but, as with any surgery, there are some risks.
- artery damage
- further testicular atrophy
- bruising, swelling, or a buildup of fluids in the area
- abdominal pain