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 men with varicose veins still have normal
sperm counts and sperm morphology and their fertility is not adversely affected.
When a man's fertility
is being investigated, the causes of male infertility may be due to a
low sperm count, which is a direct result of varicose veins causing high temperatures in the testicle.
The condition is found almost exclusively on the left hand side. It is due to the left testicular vein empting vertically into the renal vein a long way up.
The varicosities form when
the valve system between these two veins fail, so that blood falls backwards into the testicle 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. It is thus much less likely to fail. The reverse flow of blood stretches and may enlarge the tiny veins around the testicle.
A varicocele can be described as a warm tangle of worms in the scrotum.
Infertility in Males
A varicose vein contributes to male infertility or sub
fertility. A varicocele 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.
Varicoceles are linked to between 30-40 percent of cases
of male infertility.
A varicocele will be surgically excised, if sperm count is
compromised in a man
trying to have children. A
is the only conclusive means of assessing if the varicocele has affected a male.
under this condition may extend beyond 2 years.
Sperm count, decreased sperm motility and an increase in
the number of deformed sperm, can be expected.
Sperm will be affected when a raise in
temperature is experienced. Studies have shown, that there is a
significant improvement, as much as 70 per cent, in
the quality and/or quantity of sperm production, after
the testicles have undergone
Signs of varicoceles
In many cases, there are
no symptoms and the condition is harmless.
The testicles can function normally.
varicose veins can be experienced 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 varicoceles are
prominent in size, displaying as a large scrotum. The veins should be
removed or treated if they ache or cause discomfort.
More often than not, they are left in place,
if no pain or infertility is experienced.
Atrophy, or shrinking, of the testicles is another sign to
look out for. When the affected testicle is smaller than the other,
repair of the varicocele is recommended. The
repaired testicle will return to normal size after a
period of time.
An athletic support can be worn to relieve discomfort if no surgery is performed.
These veins can be detected in the testicles, during a
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,
needs to be performed by a
highly trained and experienced radiologist, who will diagnose the
condition, with monitoring of the backflow in the right and left spermatic
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 of a varicocele,
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 recurrences
of the condition are experienced
using this treatment method.
The removal of the varicocele can lead to
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 varicose veins have been identified and treated.
Veins in the testicle
causing infertility in men is a treatable condition.