
What is Varicocele?
Varicocele is a term used to describe abnormally dilated veins (called the “pampiniform plexus” of veins) in the scrotum.
What are the Causative factors?
Varicoceles are believed to be caused by defective valves in the veins within the scrotum, just above the testicles. Normally, these valves regulate the flow of blood to and from the testicles. When normal flow doesn’t occur, the blood backs up, causing the veins to enlarge.
Who are get Varicocele?
It occurs in all age especially after puberty. But it has no pain or discomfort up to the 3rd or 4th grade.
What are the Different grades of Varicocele?
- grade I
- no dilated intrascrotal veins
- reflux in spermatic cord veins of the inguinal region during Valsalva maneuver
- grade II
- prominent veins at upper pole of testis
- reflux at upper pole veins during Valsalva maneuver
- grade III
- no major dilatation in supine position
- dilated veins up to lower pole of testis seen only in standing position
- reflux at lower pole veins during Valsalva maneuver
- grade IV
- dilated veins even in supine position
- reflux during Valsalva maneuver
- grade V
- dilated veins
- reflux without Valsalva maneuver
What are the Symptoms;
Usually the Varicoceles often produce no symptoms but can cause low sperm production and decreased sperm quality, leading to infertility. In some cases,
- a dull ache in the testicle(s)
- a feeling of heaviness or dragging in the scrotum
- dilated veins in the scrotum that can be felt (described as feeling like worms or spaghetti)
- discomfort in the testicle or on that particular side of the scrotum
- the testicle is smaller on the side where the dilated veins are (due to difference in blood flow)
How Varicocele diagnosed?
A testicular exam may be done while a guy is standing up so that the scrotum is relaxed. (Some abnormalities like a varicocele can be more easily felt in a standing position.) The doctor checks things like the size, weight, and position of the testicles, and gently rolls each testicle back and forth to feel for lumps or swelling. The doctor also feels for any signs of tenderness along the epididymis the tube that transports sperm from the testicles.
The spermatic cord is also examined for any sign of swelling. If the doctor thinks there might be a varicocele, he or she might do an ultrasound, which can measure blood flow and identify veins that aren’t working correctly.
Management;
Only when patient have pain & discomfort or low sperm count can go for the treatment. Surgery is the most common treatment for symptomatic varicoceles. Varicocele embolization, a nonsurgical treatment performed by an interventional radiologist, is as effective as surgery with less risk, less pain and less recovery time.
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