Description

A varicocele (VAR-ih-koe-seel) is an enlargement of the veins within the loose bag of skin that contains the testicles (scrotum). These veins transport oxygen in the blood from the testicles. A varicocele occurs when the blood stagnates in the veins, instead of circular efficiently out of the scrotum.

Varicoceles usually form during puberty, and they develop over time. That may cause some discomfort or pain, but often do not produce symptoms or complications.

A varicocele can cause poor development of the testicles, low sperm production, or other problems that can lead to infertility. Surgery for the treatment of varicocele may be recommended to treat these complications.

Symptoms

A varicocele occurs usually on the left side of the scrotum and often produces no signs or symptoms. Possible signs and symptoms may include:

  • Pain. A dull pain or discomfort is more likely when standing up or late in the day. Lying down often relieves the pain.
  • A mass in the scrotum. If the varicocele is large enough, a mass as a "bag of worms" can be visible above the testicle. A small varicocele may be too small to see, but perceptible to the touch.
  • Different size of the testicles. The affected testicle may be noticeably smaller than the other testicle.
  • The infertility. A varicocele can lead to difficulty conceiving a child, but not all varicoceles cause infertility.

When to see a doctor

Annual wellness visit for children are important for monitoring the development and health of the testicles. It is important to schedule and keep these appointments.

A number of conditions that could contribute to pain, swelling or a mass in the scrotum. If you experience any of these, consult your health care provider to obtain a timely and accurate diagnosis.

Causes

The testicles receives oxygen-rich blood from two arteries, testicular — an artery to each side of the scrotum. In the same way, there are also two veins testicular to the transport of oxygen in the blood back to the heart. Within each side of the scrotum, a network of small veins of the plexus pampiniform) transport the oxygen of the blood from the testicles to the main vein of the testicle. A varicocele is the enlargement of the plexus pampiniform.

The exact cause of a varicocele is unknown. A contributing factor may be the result of malfunctioning valves inside the veins that are meant to keep the blood moving in the right direction. Also, the left testicular vein follows a slightly different path than that of the right vein, a way that causes a problem with the flow of blood, most likely from the left.

When the oxygen of the blood is backing up into the network of veins that dilate (widen), the creation of the varicocele.

Risk factors

There does not seem to be important risk factors for the development of a varicocele.

Complications

Have a varicocele can make it difficult for your body to regulate the temperature of the testicles. The oxidative stress and the accumulation of toxins can result. These factors can contribute to the following complications:

  • Good for testicular health. For children going through puberty, a varicocele can inhibit the testicular growth, the production of hormones, and other factors related to the health and function of the testes. For men, a varicocele can result in the gradual contraction due to loss of tissue.
  • The infertility. A varicocele does not necessarily cause infertility. An estimated 10% to 20% of men diagnosed with a varicocele experience difficulty conceiving a child. Among men with fertility problems, about 40 percent have a varicocele.

Diagnosis

Your health care provider can diagnose a varicocele by visual inspection of the scrotum and by touch. What is more likely to be examined while lying down and standing up.

When you are standing, your doctor may ask you to take a deep breath, maintain, and support the bottom, similar to that of the pressure during a bowel movement. This technique (Valsalva maneuver) can make a varicocele is more easy to browse.

Image test

Your doctor may want you to have an ultrasound examination. The ultrasound uses high-frequency sound waves to create images of the internal structures of your body. These images can be used for:

  • To confirm the diagnosis or to characterize the varicocele
  • Delete the other condition as a possible cause of the signs or symptoms
  • Detect an injury or another factor, obstructing the flow of blood

Treatment

A varicocele do not often need to be treated. For a man who suffers from infertility problems, surgery to correct a varicocele may be a part of the fertility treatment plan.

For teenagers or young adults, generally those that do not seek fertility treatment — a health care provider may suggest annual checkups to monitor changes. Surgery may be recommended in the following situations:

  • A testicle that shows a delay in the development
  • Low sperm count or other sperm irregularities (usually only tested in adults)
  • The chronic pain is not managed by pain medication

Surgery

The purpose of the surgery is to seal off the affected vein to redirect the blood flow to healthy veins. This is possible because the other two of the artery and the vein supply systems of circulation of blood to and from the scrotum.

The results of the treatment may include the following:

  • The affected testicle may eventually return to its expected size. In the case of a teenager, the testicle can "catch up" in the development.
  • The sperm count can be improved, and the sperm irregularities may be corrected.
  • The surgery may improve the fertility or improve the quality of semen for in vitro fertilization.

Risks of surgery

Varicocele repair presents relatively few risks, which may include:

  • Accumulation of fluid around the testicle (hydrocele)
  • The recurrence of the varicocele
  • Infection
  • The damage to an artery
  • Chronic testicular pain
  • The collection of blood around the testicles (hematoma)

The balance between the benefits and the risks of surgery shift if the treatment is only for the management of pain. While that varicoceles can cause pain, the majority do not. A person with a varicocele may have testicular pain, but the pain can be caused by something more: an unknown or have not identified the cause. When the varicocele surgery is performed primarily to treat pain, there is a risk that the pain may get worse, or the nature of the pain may change.

Surgical procedures

Your surgeon can stop the flow of blood through the testicular vein by stitching or trim the closure of the vein (tubal ligation). Two approaches are commonly used today. Both require general anesthesia and an outpatient procedure that usually allow you to go home the same day. The procedures include:

  • Microscopic varicocelectomy. The surgeon makes a small incision low in the groin. The use of a powerful microscope, the surgeon identifies and products linked to several small veins. The procedure usually lasts 2 to 3 hours.
  • Varicocelectomy, laparoscopic. The surgeon performs the procedure using a video camera and surgical tools attached to the tubes that pass through a few small incisions in the lower abdomen. Because the network of veins are less complex above the groin, there are fewer veins to flirt. The procedure usually takes 30 to 40 minutes.

Recovery

The pain from this surgery is usually mild, but may continue for several days or weeks. Your doctor may prescribe pain medication for a limited period of time after the surgery. After that, your doctor may advise that you take without a prescription for pain medication, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others) to relieve the discomfort.

It'll most likely be able to return to work about a week after the surgery and get back to exercising about two weeks after the surgery. Ask your surgeon about when you can resume your daily activities or when you have sex.

Alternative to surgery: Embolization

In this procedure, a vein is blocked primarily by the creation of a small dam. A doctor who specializes in images (a radiologist) is inserted a small tube into a vein in the groin or the neck. A local anesthetic is used at the insertion site, and you may be given a sedative to reduce discomfort and help you relax.

The use of images on a monitor, the tube is guided to the treatment site in the groin. The radiologist releases coils or a solution that causes scarring to create an obstruction in the veins testicular. The procedure lasts about an hour.

The recovery time is short, with only a slight pain. It'll most likely be able to return to work in 1 to 2 days and return to exercise after about a week. Ask your radiologist when you can resume all activities.

Lifestyle and home remedies

If you have a varicocele that cause minor discomfort, but it does not affect your fertility, you can try the following to alleviate the pain:

  • Take nonprescription pain medicine, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others).
  • Support to the scrotum by wearing an athletic supporter or setting writings.

Preparing for your appointment

A varicocele that does not cause pain or discomfort — which is common — it can be diagnosed during a routine checkup. It can also be diagnosed during a more complex process of diagnosis to the treatment of fertility.

If you are experiencing pain or discomfort in the scrotum or groin, you should be prepared to answer the following questions:

  • How would you describe the pain?
  • Where are you experiencing?
  • When did it start?
  • Does anything relieve the pain?
  • It is constant or comes and goes?
  • Have you had any injury in the groin area or on the genitals?
  • What medications, dietary supplements, vitamins, or herbal remedies, do you take?
Symptoms and treatment of Varicocele