Varicocele is a collection of enlarged veins next to or above the testicle. The affected veins are the veins located within the spermatic cord. Spermatic cords are tubes that connect the testicles to the abdomen and contain the arteries, veins, lymphatics of the testicles, and the vas deferens that carry sperm. These veins in the spermatic cord cannot be noticed in normal people, but in varicocele formation they can be felt by manual examination or in very advanced cases they can even be seen visually. It can be said that it is a similar situation to varicose veins in the legs.
Varicocele is a very common condition and occurs in one in every 7 men and most often between the ages of 15-25. It is often on the left side, less commonly on both sides and very rarely on the right side.
Symptoms: Varicocele often has no symptoms and may cause little pain. . Pain can range from a sharp ache to a dull discomfort. The pain may increase with prolonged standing or strenuous physical activity or later in the day and is often relieved by lying on your back. Asymptomatic cases are noticed during routine physical examination or infertility research.
What problem does varicocele cause:
Studies have shown that men with varicocele are more likely to suffer from infertility than men without varicocele. is seen at a higher rate. However, many people with varicocele are not infertile. Although the reason for this is not known exactly, it is suggested that the blood accumulating in the enlarged veins may cause an increase in temperature in the testicles, leading to insufficiency in sperm production, lack of movement and deformity.
If varicocele occurs during the developmental period, it may affect the development of the testicles and cause the testicles to remain smaller than normally expected. .
Is a special test required for varicocele: It is often seen in young people. There is no need for a special test for varicocele seen in men. It is easily diagnosed by a doctor's physical examination. In infertility research, it would be appropriate to perform a spermiogram (semen test) to evaluate sperm quality. In some special cases, especially if varicocele occurs after the age of 40 or if there is only a significant varicocele on the right side, investigation may be required for a possible intra-abdominal mass (e.g. kidney tumor, etc.).
Treatment: Varicocele. If it does not cause any symptoms such as pain or problems such as infertility, treatment is not required. Suspension type supports may be beneficial for mild pain. If the pain is frequent and very disturbing, if there is a deterioration in sperm quality and a related infertility problem, surgery can be performed. In addition, varicoceles in adolescence should be closely monitored and surgery should be performed again if there is a problem in testicular development.
There is no benefit in operating on varicoceles that cannot be detected by manual examination, which are detected only by Doppler ultrasonography. Varicocele operation is not an emergency and can be performed under elective conditions.
What is done in varicocele operation is to enter from the groin area and connect all the veins (veins) in the spermatic cord while preserving the testicular artery and lymphatics. Performing it under optical magnification or a microscope increases the chance of success and reduces the complication rate.
The answer to the question of whether varicocele surgery definitely eliminates infertility is "probably no". Varicocele surgery can increase sperm count and quality, which can increase the chance of pregnancy. But it can never be said to provide a definitive cure.
Complications of varicocele surgery may include infection, hydrocele (collection of water around the testicles) and recurrence of varicocele.
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