What is Varicocele, What are its Causes?

Varicocele, which is one of the causes of infertility in men, is the problem of varicose veins when there is an enlargement of the veins in the male testicles. When the valves in the veins that drain the dirty blood in the testicles are insufficient, the veins expand, and varicose veins occur. Although varicocele usually does not cause any symptoms, it rarely causes pain, soreness, and swelling. Varicocele, which is found in approximately 35% of men struggling with infertility problems, is seen in 15% of all men with varying severity. Early detection and treatment of varicocele are important. Otherwise, unbearable pain, reduction in testicular size, decrease in testosterone hormone production, and infertility problems may occur due to a decrease in sperm quality and number. In advanced varicocele problems, the tissue and structure of the testicles are damaged, the pain increases, the swelling reaches noticeable levels, and it is difficult to find healthy sperm.

What are the symptoms of varicocele?

Varicocele usually does not show any symptoms in the initial stages. However, in the following periods, complaints such as pain, aches, swelling, and excessive sweating can be seen in the testicles. In particular, the complaints of pain and aching increase in the case of standing or sitting for a long time and are relieved when lying down and resting. While the pain that increases in the evening after a tiring day can be at such levels that it will disturb sleep, the patient usually does not feel any pain when he wakes up in the morning. As the disease progresses, the enlargement of the vessels becomes visible even to the naked eye. Although no complaints are observed, varicocele problems can be detected in patients who applied to the doctor with infertility problems after routine tests and examinations.

What causes the varicocele?

When there is a problem in the valves of the veins that provide blood transfer to and from the testicles, the veins enlarge, and a varicocele problem occurs. When the vascular valves do not work in full function, dirty blood is accumulated in the veins and varicose veins occur just like in the legs. Although the factor that causes the insufficient functioning of the vascular valves is not known exactly, it is known that this disorder generally initiates in the adolescence period. Varicocele, which is mostly seen in the left scrotum, can occur in both testicles. Whether a varicocele occurs in one or both testicles, it affects not only the testis with varicocele but also the quality of sperm produced by both testicles.

How is the varicocele diagnosed?

Although there are many advanced medical techniques to diagnose varicocele, the most successful and easy diagnostic technique is the manual and visual physical examination of the doctor. Along with the physical examination, methods such as color or normal Doppler stethoscope, thermography, scrotal ultrasonography, scintigraphy, and venography are used While a physical examination is sufficient for doctors who are experts in this field, varicocele is diagnosed by applying color Doppler stethoscope technique in cases where there is doubt in the physical examination.

How is the varicocele treated?

First of all, it should be noted that there is no need for treatment in the varicocele problem that does not cause any complaints or symptoms. Varicocele is treated by surgical operation. If the sperm count and quality are found to be sufficient in the sperm test, surgery is not necessary. On the other hand, if the sperm count and quality are low, then surgery is applied. Although the success rate of the surgery is 95%, the sperm count, motility, and quality of the man increase by 70% after the treatment. In the treatment of varicocele, surgery is performed microscopically, and this operation takes about half an hour. A few hours after the operation, which does not adversely affect the patient’s daily routine and work conditions, the patient can return home and go to work the next day. In the sperm test performed 3 months after the operation, approximately 60% increase in sperm count and quality is observed compared to the preoperative period. After the treatment, the patient should go to the doctor’s control at regular intervals and should be controlled regularly. Controls are much more important, especially in patients who plan to have a baby.

Why does the varicocele cause infertility?

For healthy sperm production in the testicles, the dirty blood in the testicles must be emptied regularly and the temperature of the testicles must remain at a certain level. However, in the varicocele problem, toxic metabolites in this dirty blood, which cannot be excreted because there is a disorder in the dirty blood flow from the veins, disrupt the sperm structure and the dirty blood increases the temperature of testicles. It is not possible to make a judgment that varicocele causes infertility in all men. However, it is possible to say that 70% of varicocele patients cannot have a baby in a natural way without treatment. Because varicocele reduces the sperm count, motility, and maturity.

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