Varicoceles are a result of abnormal enlargement of veins in the scrotum. It is one of the most common causes of infertility in men. Statistics reveal that varicoceles are present in 15% of all men and are present in 40% of men diagnosed with infertility. Varicoceles are similar to the varicose veins in the legs. It is generally common among young men.
Cause of Varicoceles
The exact cause of this condition is not known. It is reported that it could be due to some problem with the blood flow in the spermatic cord, which carries blood to and from testicles.
Symptoms
In most of the cases, there are no apparent symptoms of Varicoceles.
Few people experience the following symptoms:
Pain: While sitting or standing for long period
Swelling: Swelling in the testicles
Fertility Problems: Varicoceles is mostly diagnosed during investigation of infertility causes. Decreased sperm count, decrease in the quality of sperms and decreased motility of sperms are associated with varicoceles.
Testicular Atrophy: Another symptom of varicoceles is the shrinking of the testicles.
Diagnosis
It is normally diagnosed by doctors through a physical examination or through an ultrasound of the scrotum.
Varicoceles and Infertility
To accomplish fertilization and development of an embryo, it is important that a man’s semen must have enough sperms which are healthy and able to move properly through a woman’s vagina, the uterus upto the fallopian tubes where the women’s egg is released and fertilization occurs.
The varicoceles in a man, raise the temperature of testicles, which in turn affects the development of sperm. The increased temperature decreases the production of testosterone (the male hormone), which leads to decrease in the number of sperms produced and also affects the quality of sperms and their motility. In severe cases of varicoceles, no semen is produced.
The increased temperature in the testicles also causes oxidative stress which is known to damage the sperm’s DNA and outer coating.
Treatment of Varicoceles
Varicoceles are treatable. Varicoceles can be reversed using both surgical and non-surgical treatment options. Post treatment, there is significant improvement reported in the sperm parameters and sperm DNA fragmentation is also seen to be decreased. The different treatment options available are as follows:
Open Varicocelectomy:
In open varicocelectomy, an incision is made in the groin with the aim to access the blood vessels that are contributing to the varicocele. These blood vessels are then tied off.
Laparoscopic Varicocelectomy:
As the name indicates, it is a minimal invasive surgery where three incisions are made in the abdomen. Laparoscopic instruments are inserted through the incisions to cut and tie off the swollen veins.
Microsurgical Varicocelectomy:
It is similar to the Open Varicocelectomy where an incision is made in the groin. The only difference is that the surgeon uses a microscope to access the blood vessels and tied them off.
Varicocele Embolization:
Varicocele Embolization is also a minimal invasive procedure. It is an image-guided procedure that uses a catheter to place tiny coils in the blood vessel to block off and divert blood flow away from the varicocele., thus releasing pressure on the veins.
Recovery Post treatment
Varicocele repair is often done on an outpatient basis and you can go back to work a day or two after surgery. However, you will be advised to avoid stringent activities and exercise for about two weeks. Pain killers are advised for few days after the surgery.
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