Varicocele - causes, symptoms, diagnosis and treatment
Medically Reviewed by Dr Sravya, MBBS, MS
Introduction
Enlargement of pampiniform plexus veins in the scrotum is called Varicocele. It shrinks testicles, decreases sperm production, quality and leads to infertility. The symptoms of varicocele occur near the scrotum and are similar to varicose veins in legs.
This disease is common in males. According to the American Urological Association, when puberty hits between the age of 15-25 the chances are high. About 10-15 of every man in 100 experience this.
They do not affect sperm production and are usually painless but sometimes Varicocele can cause testicular pain that may come and go. Good news! This health issue is not life threatening and on top of that treatment is not a necessity unless you are in pain. It has to be considered if the person is trying to have a biological child. A health care provider can diagnose this condition and suggest a proper treatment.
What causes Varicocele?
A series of valves in the testicular veins prevent the blood exiting from the testicles. Sometimes these valves don’t close completely and blood flow starts backward into the testicles without emptying into the body.The enlargement of veins in the scrotum, caused by defects in the valves of the spermatic cord veins, leads to Varicoceles.This commonly takes place during puberty, when the testicles are undergoing rapid growth. When these veins become enlarged, overheating of testes lowers sperm production and function that affects fertility.
Possible symptoms of Varicocele
- Pain or feeling heaviness in the testicles
- Infertility
- Slow growth of left testicle
- Slow growth of left testicle
- Shrinking of testicles
- Shrinking of testicles
- Dilated veins in the scrotum can be seen
- Change in the size of one or more testicles
- Change in the size of one or more testicles
Screening of varicocele
- Physical examination by physician to know the cause of Varicocele
- Physician performs Valsalva Maneuver – test to assess enlarged veins in scrotum during holded breath and strain.
- Pelvic ultrasound - noninvasive imaging test that provides view of veins in the testicles
- Semen analysis – semen samples are collected in the lab and tested for quality of sperm, to check the fertility.
- Blood test – testosterone and follicle stimulating hormone levels are to be checked in blood samples after confirming Varicocele to grade its severity.
Grading of Varicocele
The size of the lump in testicle helps to classify Varicocele grades from 0-3.
- Grade 0 – is only seen with ultrasound
- Grade 1 – only felt when the doctor performs Valsalva Maneuver
- Grade 2 – is felt by doctor even when Valsalva Maneuver was not performed
- Grade 3 – is largest, changes the shape of scrotum
Complications of Varicocele
They increase the risk of other complications like
- Low testosterone
- Azoospermia
- Infertility or low fertility
- Testicular atrophy
How to get rid of varicocele
- Treatment is dependent on the severity of Varicocele. It is not always necessary to treat. Treatment is necessary if it causes pain, infertility, testicular atrophy.
- Varicocelectomy Surgery to correct blood flow from abnormal veins to normal veins
- Varicocele embolization It is less invasive and a one day procedure. Small catheter is inserted into the groin or neck vein. A coil is placed into the catheter and passed into varicocele, this blocks blood from getting into abnormal veins.
- Laproscopic surgery It is performed by using general anaesthesia, a small incision is made to insert tubes that hold a special camera to see inside.
Home remedies for Varicocele
- Exercises - since this condition is linked to blood circulation. Mild exercises that improve blood flow will be beneficial.
- Ice pack - a cold compress or ice pack can relieve pain, discomfort and swelling
- Use a jock strap - this type of underwear provides extra support to the scrotum
- Avoid tight underwear - tight underwear puts unnecessary strain on scrotum and pressurizes veins, worsening the situation
- Get rest - lying flat back can ease the pressure of veins in legs and scrotum
- Add fiber -fiber food smooths digestion and no need to strain while passing stools.
- Avoid junk food - food that contributes to constipation should be avoided.
- Kegel exercises - kegel exercise involves the pelvic floor muscles, contracting and relaxing this muscles regularly improves blood flow to scrotum
- Regular pain medicine - best pain killer medicine should be taken after consulting a doctor.
Conclusion
Varicoceleis a common condition that affects people at different stages of life. Most people experience mild or no symptoms. Infertility is commonly seen with this and is typically corrected successfully with surgery . Pain after surgery is mild and can return to his daily activities within 2-3 days. Consulting a doctor and following his treatment pattern helps in speed recovery. In many cases doctors only recommend waiting and observing, rather than opting for surgery, especially if there are no symptoms. There are plenty of options to fix this issue permanently.
Frequently Asked Questions
➔ Supporting scrotum with jockstrap or brief style underwear help varicocele pain.
➔ Lying on your back helps to drain varicocele and relieves pain.
➔ Taking painkillers – acetaminophen, ibuprofen etc. subsidies pain
Semen quality gets better within 6 months to 1 year. Semen analysis can be performed for 3-4 months to check the sperm quality.
As a rule varicocele with no symptoms were not treated as they do not cause health problems. However, semen analysis can be performed to check whether sperm quality is affected or not.
Most males with varicose will not have any problem. Semen analysis is highly recommended after the age of 16 if a normal repeating test for every 2-3 years is needed to overcome fertility issues.