Varicocele is a varicose vein of the testicle. Non-hazardous disease and often does not need treatment. But it becomes a cause of infertility, because affects the quantity and quality of sperm produced.
In patients with an established diagnosis of infertility, 40% revealed varicocele. According to statistics, every sixth man aged 16 to 25 years old suffers from varicocele.
Over time, the disease progresses and can lead to complete infertility, because atrophy of testicular tissue occurs and spermatogenesis is impaired.
Bilateral varicocele is rare. This is due to the anatomical structure: the vein of the left testicle is much longer than the right. It has a higher pressure gradient, which quickly leads to the development of varicose veins. Therefore, the process often occurs on the left.
Varicocele in men - causes
The causes of varicocele in men are varied. These include:
- Valvular defects of the scrotum veins involved in the regulation of blood flow to the testicles;
- anatomical features of veins;
- complications caused by kidney diseases or pathological processes in the pelvis and retroperitoneal space, leading to compression of the renal veins;
- Renal vein thrombosis (rarely);
- kidney tumors (rarely).
But most often found primary (congenital) varicocele.
Risk factors leading to the fact that the above causes of varicocele in men are exacerbated and cause the disease are:
- heavy physical exertion;
- constipation;
- overweight;
- irregular sex life;
- congestion in the pelvis.
Varicocele in men - symptoms
The severity of symptoms of varicocele in men depends on the degree of expansion of the veins of the spermatic cord. At the initial stages, the disease does not manifest in any way, does not cause any negative feelings. In the future, the longer the pathological process takes place, the more pronounced the symptoms.
The main symptoms of varicocele in men are:
- pain;
- testicular atrophy;
- change in venous pattern;
- problems with fertility.
With varicocele in men, symptoms appear gradually, developing over a period of time.
1. Pain in the scrotum of a dull, aching, oppressive nature; can vary from a slight discomfort to intense cutting. Due to increasing pressure in the veins, the pain intensifies towards the end of the day, especially after physical exertion and with a prolonged sitting or standing position, also in hot weather. Relief occurs when lying on your back.
2. With testicular atrophy, complaints of dysfunction arise. On examination, when the testicle is lowered, asymmetric sagging of the scrotum and a decrease in the testes (testicle) in size are observed.
3. A change in the venous pattern is observed visually. As the process develops, the dilated veins increase.
4. Problems with fertility - infertility develops. It is associated with a decrease in the number of sperm, a decrease in their motility, and a change in quality - deformed spermatozoa appear. It is believed that the reason for this is an increase in testicular temperature due to the development of varicocele.
In medicine, there are four types of varicocele classifications. One of them, according to Lopatkin, is most often used in medical practice:
- 1 degree - expansion of the veins is detected by palpation when straining the patient in a standing position;
- 2 degree - pain is disturbed in the entire inguinal region;
- 3 degree - pronounced dilatation of the veins, a sharp decrease in the testicles, a change in their consistency.
Timely diagnosis - preventing infertility
Any changes in the scrotum and testicles are an occasion for a visit to the doctor, given the serious problem of infertility that can occur with varicocele in men. Swelling of the testicles, enlargement of the scrotum, one-sided or two-sided, various unpleasant or painful sensations can be symptoms of varicocele in men. But these same symptoms can be manifestations of some more serious diseases. Therefore, an appeal to a urologist is necessary to avoid more serious problems in the future.
But patients, as a rule, come to the doctor when severe pain and testicular changes have already appeared. This is in most cases the third stage of varicocele. The urologist at the appointment will determine the disease and offer treatment. In doubtful cases, an ultrasound scan will be performed to detect testicular varicose veins. At the same time, dopplerography is prescribed to detect blood reflux into the veins of the spermatic canal. To determine the degree of testicular damage, a spermogram is prescribed.
Varicocele in men - treatment
In the initial stage of varicocele in men, treatment is not required. During this period, it is necessary to observe a certain regime aimed at preventing the further development of the disease. To reduce congestion in the pelvis, it is necessary to reduce physical activity, get rid of constipation, wear comfortable underwear. If varicocele is suspected in children and in adolescence, venotonics, drugs that improve venous blood flow, can be taken. But we must remember that therapeutic treatment for varicocele in men does not exist. Symptomatic treatment can be carried out: non-steroidal anti-inflammatory drugs (NSAIDs) are prescribed to reduce pain, wearing soft and comfortable underwear is recommended. But this is not a solution to the problem.
Surgical Treatment - Problem Solving
As the disease develops, when discomfort and pain already disrupt the usual rhythm of life, testicular atrophy develops, and many are diagnosed with infertility, treatment is required, which consists in surgical intervention. Varicocele is a purely surgical pathology and should be treated surgically. Such a concept as “treatment of varicocele without surgery” simply does not exist, since it is possible to correct varicose veins with varicocele only by performing a surgical manual.
Medication is prescribed after surgery and is used to correct the postoperative condition. The main goal of such therapy is to restore and maintain normal spermatogenesis in the postoperative period. Multivitamins containing microelements are prescribed, especially zinc and selenium, and androgen-containing preparations, if necessary. For pain - NSAIDs (non-steroidal anti-inflammatory drugs).
If a varicocele is detected and immediately operated on time, this pathology is completely eliminated and subsequently in most cases does not cause any discomfort. But if veins of "difficult access" became the cause, in the remote time a relapse may occur if the man did not observe basic preventive measures.
Varicocele in men - prevention
Preventive measures for varicocele should be carried out all his life, regardless of the age of the man.
Since it is impossible to prevent an existing congenital pathology or anomaly in the development of the venous network, there is no specific prophylaxis aimed at primary varicocele. But there is a set of general measures that can reduce the possibility of the progression of pathology and the development of varicocele. These include:
1. Inspection by a urologist of men aged 19 - 20 years to exclude congenital varicose veins of the testicles. It is associated with the end of puberty and the formation of genital organs by this age, therefore it is much easier to detect varicocele than in individuals under 19 years of age. If examination did not reveal varicose veins, then there is no congenital varicose vein change.
2. Examination of older men - to detect testicular varicose veins for the purpose of early diagnosis of secondary varicocele.
Prevention of an already occurring varicocele is
- correction of physical activity - it is necessary to reduce daily excessive stress;
- treatment of constipation, because frequent abdominal pressure rises and the disease worsens;
- a diet to reduce weight, because obesity also contributes to high intra-abdominal pressure;
- move more during the day: movements help to improve blood circulation and reduce congestion;
- simple exercises that will improve blood circulation in the small pelvis: bending forward, squats, spinning the pelvis, simple sipping, energetic dancing;
- regular sex life;
- refusal of alcohol;
- the rejection of the frequent and excessive use of exciting creams and ointments used to stimulate orgasm: their frequent use leads to stagnation of venous blood and the development of varicose veins;
- Surgical treatment is the most important method for the prevention of varicocele. Indeed, only in this case it is possible to avoid the further development of varicocele and prevent a dangerous complication - infertility.
