What is Varicocele?
Varicocele is the enlargement and varicose veins that drain the blood from the eggs in men. The valves that regulate blood circulation on the inner surface of these varicose veins have lost their functions and cannot drain the blood. Excessive and abnormal dilation of the veins coming out of the testicle exposes the sperm-producing cells to some toxic substances as a result of the heat effect and malnutrition in the testicle. Since these substances have an effect on the testicles, they negatively affect sperm formation and may cause infertility.
Approximately 40% of men with infertility complaints have varicocele. This rate rises to over 80% in men who have had children before but complain of secondary infertility. Varicocele can be seen in both testicles. However, due to their anatomical neighborhood, the incidence rate in the left testicle is around 85% and the incidence rate in the right testicle is around 15%. Varicocele on one side usually affects the other testicle.
What are the Symptoms of Varicocele?
Varicocele often does not cause any symptoms. However, sometimes pain in the testicles, shrinkage in the testicles, a feeling of fullness in the testicles, infertility, visible enlarged veins and palpable enlarged veins may be observed.
How is Varicocele Diagnosed?
Patients come to the doctor because of the enlarged veins in the egg they see or touch while standing. Diagnosis is usually made by manual examination by the doctor. Ultrasonography / Doppler must be performed. All patients with varicocele should have a sperm analysis after 3-4 days of sexual abstinence and their sperm count, motility and shape should be investigated. In approximately 60% of patients, sperm density and motility are reduced and their shape is distorted. Surgical treatment can be applied to men with varicocele who complain of infertility, those who complain of very intense pain, and men with varicocele whose testicles have shrunk significantly compared to the other. Varicocele may not necessarily have to have disrupted sperm values in order to undergo treatment. If varicocele is found in unmarried men and their sperm begins to deteriorate, treatment may be recommended. If the male is in adolescence, that is, he has not yet reached puberty If the patient is unable to produce sperm, it is checked whether there is a shrinkage in the testicle. If the testicle on that side has lost 10% or more of its volume, surgery is indicated.
How is Varicocele Treated?
Surgery is required for varicocele treatment. It is recommended to use a surgical microscope during surgery. It is performed through a small incision in the groin area and varicose veins are tied. The success rate of varicocele surgery varies. It takes approximately 45 minutes. Meanwhile, care should be taken not to damage other structures related to the testicle. If varicocele surgery is not performed carefully, complications such as hydrocele (fluid accumulation around the testicle) and atrophy may occur. But in recent years, thanks to advances in surgical technique, these complications are much less common. People who will undergo surgery should know this well and get information about it from the doctor who will perform the surgery. Improvement in sperm production begins to occur 3-6 months after the surgery. Sperm analysis should be performed in the 6th month after surgery. Improvement in sperm production is seen in 60-70% of patients who undergo surgery. Its effect on pregnancy is also very positive.
Men who will undergo in vitro fertilization may also be advised to switch to in vitro fertilization after varicocele surgery. In some of the operated patients, sperm values may increase slightly and in vitro fertilization can be started.
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