Varicocele of the Testicles

A varicocele is literally a collection of varicose veins surrounding a testicle. This common condition affects up to 20% of males. The majority of these men still have normal sperm counts and sperm morphology and in those instances, there is no need for concern.

In other instances, it is attributed to causes of male infertility.

The condition is found almost exclusively on the left hand side. It is because the left testicular vein empties vertically into the renal vein a long way up. The varicosities form when the valve system between these two veins fails, so that blood falls backwards under the pull of gravity.

The right testicular vein enters directly into the major trunk vein, at an angle, further down.

Therefore its valves do not have to support the same weight of blood as those in the left testicular vein and therefore are much less likely to fail.

The reverse flow of blood stretches and may enlarge the tiny veins around the testicle.

The symptoms and feel can be described as a warm tangle of worms in the scrotum.

The condition contributes to male infertility or sub fertility.

Infertility in Males

A varicose vein, such as this can trigger a fall in sperm count, through keeping hot blood pooled within the scrotum, rather than draining it away. Any increase in temperature affects sperm formation, which ideally needs a temperature of 4-7 degrees C, less than core body temperature.

Signs of varicoceles

In many cases, there are no symptoms and the condition is harmless. The testicles can function normally.

The signs of the condition can be recognized as an aching pain or discomfort, when standing or sitting for an extend period of time and pressure builds up in the veins. Lifting heavy objects can make the symptoms worse. Painful varicose veins are prominent in size, displaying as a large scrotum. They can be removed if they ache or cause discomfort. Most often though they are left in place, if no symptoms are experienced.

Atrophy, or shrinking, of the testicles is another sign to be looked for. When the affected testicle is smaller than the other, repair of the varicocele is recommended. The repaired testicle will return to normal size in most cases.

An athletic support can be worn to relieve discomfort if no surgery is performed.

Diagnosis

These veins can be detected in the testicles, during a physical examination. A reliable diagnosis will be made with ultrasound, which shows the dilatation of vessels of the pampiniform plexus to greater than 2mm. A Ultrasonography - color flow doppler performed by an interventional and experienced radiologist that will diagnose the condition, with monitoring of the back flow in the right and left spermatic veins.

Treatments

A urologist will decide on the correct treatment plan, according to the severity of the condition, as well as if pain is experienced. Infertility will also be taken into account, for a male wanting children.

Varicocelectomy, the surgical correction, is normally performed as an outpatient basis. There are three types of surgery which may be performed. Groin, abdominal or below the groin. Depending on the surgery performed and if necessary, a scrotal support can be worn for some time after surgery.

An alternative to surgery correction is a minimally invasive treatment called embolization. This procedure is performed by a radiologist. A small wire is passed through a peripheral vein and into the abdominal veins that drain the testes. Recovery time is normally less than with a surgical procedure. Fewer recurrence of the condition is experienced using this treatment method.

The removal of the varicocele can lead to normal testicular temperatures and thus an increase in sperm production, which is necessary in the treatment of infertility. An excellent rate of success can be expected once this condition is identified, and treated.

Veins in the testicle is a treatable male condition which may affect fertility.

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