Varicocele

Varicocele is an enlargement of veins in the testicle. It is similar to varicose veins in the legs.

It may result in low sperm production and decreased sperm quality which may cause infertility. This may also cause testicles fail to develop or shrink. Varicocele takes some times to develop, fortunately they are easy to diagnose and may not need treatment.

Often there are no signs and symptoms of varicocele however, it causes pain and it may be:

• vary from sharp to dull,
• increase with physical exertion,
• worsen over the course of a day,
• is decreased when lied on the back.

Varicocele’s may enlarge and become noticeable. Varicocele often impairs sperm production.

Cause of varicocele is unknown.However, varicocele is formed when the valves inside the veins in the spermatic cord prevents the blood from flowing properly and this causes the veins to dilate this may damage the testicle and cause infertility.

It develops during puberty and usually occurs in the left side due to the position of left testicular vein. One varicocele can affect both testicles.

Making a diagnosis of varicocele is done during physical examination and by performing several tests.

The doctor will conduct a physical examination to reveal a non-tender mass above the testicle. It will be palpable if the mass is large enough.

In case of a smaller varicocele, the doctor may ask the patient to stand up, take a deep breath and hold it while bearing down (Valsalva maneuver). This helps to detect abnormal enlargement of the veins.

To prove the diagnosis, certain tests may be recommended like scrotal ultrasound.

Treatment for varicocele may not be necessary always.

If the varicocele causes pain, testicular atrophy or infertility, then varicocele repair should be considered. The purpose of the surgery is to normalize the blood flow in veins. In case of male infertility, in-vitro fertilization (IVF) can be used.

Varicocele repair is required in cases like hydrocele, recurrence of varicocele, testicular atrophy, infection and damage to an artery.

Certain repair methods include:

• Open surgery - in this procedure surgeon will approach vein through groin.
• Laparoscopic surgery - a tiny instrument is passed through an incision to repair the varicocele.
• Percutaneous embolization - a radiologist inserts a tube into the in neck and groin through which instrument can be passed.

The following home remedies may be tried for pain relief:

• taking over the counter pain killers,
• wearing an athletic supporter.

There are no significant risk factors for developing varicocele. However, overweight may reduce the risk, while being taller increases the risk.

The following complications may occur:

• shrinkage of the affected testicle,
• infertility.