Varicoceles are a common cause of low sperm production cause of low sperm production and decrease sperm production and decrease sperm quality, which can cause infertility. However, not all varicoceles affect sperm production. Varicoceles can also cause testicle o fail to develop normally or shrink.
Most varicoceles develop over time. Fortunately, most varicocele is easy to easy to diagnose, and many don’t need treatment. If a varicocele causes, it often can be surgically repaired.
A varicocele often produces no sign or symptoms. Unusually, it may cause pain. The pain may:
- Increase discomfort with standing or physical exertion, especially over long periods
- Vary from sharp to dull discomfort.
- Worse/deteriorates over the course of the day
- Find the discomfort is relieved when you lie on your back.
Over time, varicoceles can enlarge and develop more noticeable in young men, the appearance of a varicocele diminishes sperm production and can often be fixed with treatment.
When to see a doctor.
Since a varicocele normally causes no system, it may commonly require no treatment. Varicoceles may be found during a fertility assessment or a routine physical exam.
Although, if you experience pain or swelling in your scrotum, or did cover a mass on your scrotum, discern that your testicles are different sizes or develop a varicocele in your youth, or you are having problems with fertility, contact your doctor. Some conditions can cause a short mass of testicular pain, some of which need prompt treatment.
Your spermatic cord moves blood to and from your testicles. It is not certain what causes varicoceles. Although many specialists believe a varicocele develops when the veins in the cord prevent your blood from flowing properly. The resulting backup causes the vein to stretch (dilate). This can then result in damage of the testicle and can worsen fertility as an effect.
Varicoceles often form during puberty. Varicoceles commonly occur on the left side, most likely due to the location of the left testicular vein. However, a varicocele in one testicle can affect sperm generation in both testicles.
There does not appear to be any significant risk factors for developing a varicocele. However additional research suggest that being overweight may reduce the risk while being taller can increase the risk
A varicocele may cause:
Shrinking occurring in the injured testicle (atrophy). The bulk of the testis contains sperm-producing tubules. When damaged, as from varicocele, the testicle shrinks and softens. It’s not obvious what triggers the testicle to contract, but the malfunctioning valves enable blood to pool in the veins, which can end in higher pressure levels in the veins and susceptibility to toxins in the blood that may cause testicular destruction.
Infertility Varicoceles can keep the local temperature around the testicle higher than it should be, affecting the formation of sperm and the sperm’s movement and function.
Test and diagnosis
Your doctor will do a physical exam, which can show a non-tender mass above the testicle that feels something like a bag of worms. If the varicocele is sufficient in size, your doctor will be able to touch and observe it. If you have a smaller varicocele, your doctor may ask you to stand-up while taking deep breaths during evaluation. During this time the doctor will also ask you to bear down or place yourself in the Valsalva maneuver; this will assist your doctor to detect irregular enlargement of the veins.
If the physical exam is uncertain, your doctor may order a social ultrasound. This test, which use high-frequency sound waves to create precise images of structures inside your body may be used to ensure there is another reason for your symptoms. In certain cases, further imaging may be suggested to eliminate other causes for the varicocele, such as a tumor compressing the spermatic vein.
Treatments and drugs
Varicocele treatment may not be needed. However, if your varicocele causes, testicular atrophy, pain, infertility, or if you are considering assisted reproductive techniques, you may want to thin about getting a varicocele repair.
The purpose of surgery is to seal off the effect vein to predict the blow flow into healthy veins. In cases of male infertility therapy of a varicocele may help fix or cure infertility or improve the quality of sperm if procedures such as in-vitro fertilization (IVF) are to be used.
Varicoceles commonly emerge in adolescence and the likely effect in worsened sperm production. Despite the reduced sperm quality overall, many men with varicoceles continue to have sufficient sperm quality to achieve a pregnancy later in life.
Strong indications to repair a varicocele in adolescents include progressive testicular atrophy, pain or abnormal semen analysis results. Although treatment of a varicocele improves sperm characteristic, it is not clear if an untreated varicocele points to the progressive worsening of sperm quality over time.
Varicocele repair options have relatively few risk, which may include:
- Buildup of fluid around the testicles (hydrocele)
- Testicular atrophy
- Recurrence of varicoceles
- Damage to an artery
Repair Methods include:
Open surgery. This treatment usually is done in an outpatient setting, with a local or general anesthetic. Usually, your surgeon will approach the vein through your groin (inguinal or sublingual) however it also is possible to make an incision in your abdomen or below your groin.
Recent developments in varicocele repair have to lead to a decline of post-surgical complications. One advancement is the use of the surgical microscope, which allows the surgeon to examine the treatment area better during surgery. Another is the usage of Doppler ultrasound, which helps guide the procedure.
You may be able to return to regular, nonstressful actives after two days. As long as you are not uncomfortable, you may return to more strenuous activity, such as exciting, after two weeks.
Pain from this surgery regularly is mild but may remain for several days or weeks. Your doctor may prescribe pain medication for a certain period after surgery. Following that, your doctor may suggest you take over-the-counter (OTC) medications, such as acetaminophen(Tylenol) or ibuprofen(Advil, Mortin IB, and others) to relieve any discomfort.
Your doctor can advise you not have sex for a period, Most often, it will take numerous months after surgery before improvements in sperm quality can be observed with semen analysis. This is because it takes approximately three months for new sperm to develop.
Open surgery using a microscope and sublingual approach typically has the highest success rates when compared with other surgical options.
Laparoscopic surgery. Your surgeon produces a small incision in the abdomen and passes a small instrument into the incision to see and to repair the varicocele. This procure requires general anesthesia.
Percutaneous embolization. This procedure is done under local anesthesia on an outpatient basis. A radiologist injects a tube into a vein in your groin or neck through which instruments can be passed. The doctor views the enlarged veins on the monitor and released coils or a solution that causes scarring to create blockages in the testicular veins, which interrupts the blood flow and repairs the varicocele. This is not a widely used procedure.