Varicocele

21:56 - 4 May , 2021

Disease

What is Varicocele?

It refers to a varicose vein in the scrotum, being responsible for sterility due to low sperm production or its low quality, as well as testicular atrophy or its retraction. Its diagnosis is usually easy and most do not require treatment, but if it causes symptoms, a surgical repair is needed. This condition’s origin is uncertain, but it is believed to be due to blood flow restriction in the veins of the spermatic cord that supply blood to the testicles causing vein dilation, usually in the left testicle.

Symptoms

There are no symptoms most of the time, but when they do, they include the following:
  • Mild to severe pain that increases when you perform physical activities and as the day goes by.
  • Infertility.
Usually, the varicocele grows until it becomes evident, causing inflammation and testicular pain, so if you have these symptoms, you notice a scrotal bulge, and there is a difference in size between your testicles, see your doctor immediately. 

Diagnosis and treatment

Once your doctor analyzes your symptoms and your medical history, he or she will perform a physical examination in which he or she will feel your testicles to detect any bulge, although if it is not detected due to being small, you will be asked to perform the Valsalva’s maneuver, which consists of inhaling deeply, holding your breath, and pushing so that the veins stand out.  If no conclusive evidence is identified, they will order a scrotal ultrasound or MRI to make sure there is no underlying condition causing the varicocele.  It is most likely that an asymptomatic varicocele does not need to be treated, but if you have pain, testicular atrophy, and sterility the indicated treatment is surgery to seal the affected vein and channel the blood into healthy veins, which automatically improves the quantity and quality of sperm, providing a solution to sterility. 

Types of surgeries:

  • Open: 
It is usually an outpatient procedure in which an incision is made in the abdomen or groin to reach the vein and repair it with the help of Doppler ultrasound or a surgical microscope. The results are usually excellent and the recovery time is fast (two days to carry out your daily activities and two weeks at the latest to exercise). 
  • Laparoscopic: 
A catheter with a small camera is inserted through a small incision in the abdomen to observe and repair the varicocele. Recovery is faster and less painful. Both surgeries are low risk, but in some cases certain complications may occur, such as:  
  • A new varicocele.
  • Infections. 
  • Arterial damage.
  • Hydrocele, which is the accumulation of fluid in the testicles.
A different alternative to surgery is percutaneous embolization, which involves inserting a catheter into a neck or inguinal vein to channel a substance that cauterizes the affected testicular vein to prevent blood flow and redirect it into normal veins. Recovery time is similar to surgery.  In ABC Medical Center’s Internal Medicine Department, we offer health care services with the highest quality and safety, from the prevention, diagnosis, timely treatment, and monitoring of infectious, respiratory, endocrinological, dermatological, rheumatic, nephrological, gastrointestinal, and hematological pathologies of both chronic-degenerative diseases and acute conditions, through a comprehensive and multidisciplinary model.

Fuentes:

  • mayoclinic.org
  • medlineplus.gov
  • elsevier.es
  • topdoctors.es
  • childrensmn.org
  • medigraphic.com
  • Vela CI, Caravia PI, Milián ER. Actualización de aspectos anatómicos, fisiopatológicos y diagnóstico del varicocele. RCU. 2019;8(2):149-163.
  • Baños HI, de Armas AI, Ramos PK, et al. Disfunción eréctil, niveles de testosterona y su relación con la presencia de varicocele. RCU. 2018;7(2):81-88.
  • Baños HI, de Armas AI, Ramos PK, et al. Relación entre varicocele, disfunción sexual y niveles séricos de testosterona. Rev Ciencias Médicas. 2018;22(3):486-484.
  • Chou RA, Fragas VR, Hernández SDR, et al. Varicocele bilateral e infertilidad: evaluación de dos técnicas quirúrgicas. RCU. 2013;2(1):53-69.
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