Varicocoele
What is Varicocele?
Varicocele is a medical condition characterized by the enlargement and dilation of the veins within the scrotum, the loose pouch of skin that holds the testicles. It is similar to varicose veins that occur in the legs but affects the veins in the scrotum. Varicoceles usually occur on the left side but can also be present on both sides.
Causes:
The exact cause of varicocele is not always clear, but it is believed to be related to faulty valves in the testicular veins. These valves normally regulate blood flow, but when they don’t function properly, blood can pool and cause the veins to enlarge.
Symptoms
Many varicoceles do not cause noticeable symptoms and are often discovered during a routine physical examination or fertility evaluation.
Some common symptoms include a dull ache or discomfort in the scrotum, especially after prolonged standing or physical activity.
Visible swelling or enlargement of the veins in the scrotum, which may resemble a bag of worms.
Diagnosis:
A diagnosis can be obtained with:
Physical examination: The doctor will feel the scrotum to check for any abnormal swelling or enlargement of the veins.
Ultrasound: This imaging test uses sound waves to create a picture of the veins and can confirm the diagnosis of varicocele.
Complications:
Varicoceles are generally harmless and don’t often lead to serious complications. However, in some cases, they may be associated with:
Reduced fertility: Varicoceles can interfere with sperm production and quality, leading to male infertility in some cases.
Testicular atrophy: In rare cases, long-standing and severe varicoceles may cause the affected testicle to shrink over time.
Treatment:
Treatment for varicocele may not always be necessary, especially if the condition is not causing significant symptoms or fertility problems. However, if treatment is recommended, options may include:
Observation: If the varicocele is small and not causing any issues, the doctor may choose to monitor it regularly without intervention.
Supportive measures: Wearing supportive underwear or a scrotal support may help alleviate discomfort.
Embolisation: A minimally invasive option that treats the varicocele by placing a small needle in a vein in the wrist or groin and then occluding the varicocele with coils to divert blood into smaller properly functioning veins.
Surgery: Varicocelectomy is a surgical procedure to repair the affected veins. It is typically done when the varicocele is causing significant symptoms or affecting fertility. Varicocelectomy can be done via a small incision in the groin (open) or via a laparoscopic or robotic approach (key-hole).