Varicocele

Common symptoms of varicocele include:

• A lump in one of the testicles
• Swelling in the scrotum
• Dull recurring pain in the scrotum
• Infertility

There is no known explanation of what causes varicocele. However, multiple studies have pointed that it could develop due to a problem with blood flow in the spermatic cord. The cord is responsible for carrying blood to and from the testicles. It contains the veins, arteries, and nerves to support these glands. If the valves in the veins don’t work correctly, the blood backs up, and the veins get enlarged. The varicocele develops slowly over time.

In teen boys, it may occur due to unprecedented growth they might go through during puberty. This means that the testicles need more blood as they develop, which might cause this condition. With this, there might be a poor circulation of blood, which may result in higher blood temperature. This also raises the temperature of the testicles, which can be a barrier to sperm production.

Varicocele is often characterized into different grades, depending on the condition. These include: 

• Grade I: The Grade I varicocele means that the dysfunctional veins are not visible. The doctor usually detects them during the physical examination while the patient performs the Valsalva maneuver.
• Grade II: The Grade II varicocele means that the veins are not visible but can be detected during a physical exam without needing a Valsalva maneuver.
• Grade III: In this category, the varicocele is easily identified through the scrotum without the need for physical examination.

Your doctor will ask for your medical history along with your symptoms. He / She will also perform a physical examination to check for the varicocele. The doctor may also recommend a scrotal ultrasound test to check the spermatic veins and get detailed information about the condition. Depending on this, the doctor will grade the varicocele.

Varicocele treatment may not be necessary. However, you may need treatment if the varicocele causes other issues like pain, testicular atrophy, infertility, and more. Depending on the condition, your doctor may recommend the following Varicocele treatment: 

• Varicocelectomy: During this procedure, the surgeon makes an incision in your groin and uses a magnifying glass or microscope to see the veins. The surgeon then ties off the abnormal veins and directs the blood flow to the healthier veins. This is gold standard treatment of varicocele.
• Varicocele embolization: In this varicocele treatment procedure, the surgeon inserts a small catheter into the groin or neck vein. A coil is then placed into the catheter and moves into the varicocele. The coil blocks the blood flow to the dysfunctional vein and redirects it to the normal veins.
• Laparoscopic surgery: In this surgery, the surgeon makes a small incision in the abdomen and passes a tiny instrument and a special camera to see the veins and repair the varicocele.

Varicocele doesn’t usually cause any complications. However, there might be some risk of infertility due to this condition. Multiple studies have found that about 35 to 44 percent of men with primary infertility suffers from varicocele. Apart from this, varicocele also leads to testicular atrophy or shrinkage of testicles.

Varicocele is often harmless and does not require any varicocele treatment. In addition, the long-term outlook for this condition is usually positive. If you have surgery, your sperm count may increase, and you will have lesser scrotum pain.

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