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Varicocele: Causes, Symptoms, Diagnosis and Treatment

  • Published on July 24, 2023
Varicocele: Causes, Symptoms, Diagnosis and Treatment

According to NCBI, 4.4% to 22.6% of the general population are affected by varicocele condition. It affects 21%-41% of men with primary infertility and 75%-81% of those with secondary infertility. This condition can be alarming for men experiencing difficulties in performing daily activities. 

What is Varicocele?

Varicocele is a medical condition characterised by scrotal vein expansion, resulting in decreased blood flow and blood pooling in the testicles. It is a rather prevalent ailment that primarily affects men during their reproductive years. While varicoceles rarely result in severe symptoms, they can cause fertility issues or discomfort in day-to-day life. This blog seeks to provide detailed information on varicocele, including causes, diagnosis and its effective treatment options.

Causes of Varicocele

Although the specific causes of varicocele are unknown, various factors may contribute to its development. The primary reason is believed to be faulty valves within the testicular veins, which reduces blood flow and causes vein growth. The following are some of the most common risk factors for varicocele development:

Abnormal malfunction: Malfunctioning valves in the testicular veins disturb the normal flow of blood, causing it to pool and expand the veins.

Hereditary: Some reports also suggest a genetic propensity to varicocele. Close family members who have varicoceles may be at a higher risk of having the disorder.

Hormonal Imbalances: Hormonal imbalances, particularly elevated oestrogen levels, may lead to the development of varicocele. This can interfere with the proper function of venous valves.

Injury: Any trauma or injury in veins present in the scrotum region that happened due to physical sports, accidents and any other significant reason can lead to varicocele. 

Nutritional Factor: Some researchers have suggested that a deficiency of nutrients can weaken the wall of veins, making them more prone to enlargement and blood pooling. 

Varicocele Diagnosis

The diagnosis of varicocele condition involves physical assessments and a few diagnostic tests. Such evaluation help experts in detecting the root cause of the condition in order to determine the effective technique for varicocele surgery. Here are a few common methods used for varicocele diagnosis:

Medical history: The doctor will ask about your and your family’s medical history to check whether its hereditary or not. 

Physical evaluation: In physical examination, the expert will ask the patient to stand up in one place in order to assess the scrotum region. The expert will evaluate the affected vein and how enlarged it has gotten, also, the doctor will put slight pressure with a finger to check the tenderness or swelling in the scrotum and its nearby region. 

Valsalva maneuver: It is a type of breathing technique that is advised to the patient while expert is holding to the testicle sac to assess the affected and enlarged veins in the scrotum. 

Ultrasound: It is an imaging test and expert commonly advises ultrasound to assess the severity of the condition in order to initiate an effective varicocele treatment. 

Doppler ultrasound: This ultrasound is typically recommended to check the blood flow in the vessels. The reports of Doppler ultrasound give a clear image of the affected region.

Semen analysis: When there is a concern regarding fertility, the expert will advise semen analysis test to detect the sperm motility rate including sperm quality and count. Later the fertility treatment for varicocel is advised based on the reports of the patient. 

Different Grades of Varicocele

According to the Dublin and Amelar criteria, varicocele is classified into different grades based on its severity. Refer to the below table to understand the classification of varicocele grade-wise:

Grade Classification
Grade 0 Also, refer to as subclinical; not visible or palpable and can be detected with ultrasound
Grade 1 Palpable varicocele with the aid of the Valsalva maneuver
Grade 2 Palpable varicocele without Valsalva
Grade 3 Visible varicocele 

Varicocele Treatment

After running a thorough diagnosis, an expert will determine the type of method for varicocele surgery in order to treat it effectively. The primary goal of the varicocele treatment is to manage the symptoms, prevent risks or complications and restore fertility. Here are a few common varicocele treatments recommended to patients according to the severity of the condition:

Keeping under observation: When varicoceles are asymptomatic or do not have a substantial impact on fertility, a “wait and see” strategy may be recommended. During that period, the expert can assess any changes in symptoms or reproductive status through regular monitoring and follow-up visits.

Medication: Although medication is not normally used as a main treatment for varicocele, certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), may be used to alleviate pain or discomfort caused by the condition. Such painkillers allow patients to function in their day-to-day activities.

Varicocelectomy: It is a surgical technique that entails ligating or eliminating the afflicted veins. It can be done either through open surgery or through less invasive treatments such as laparoscopy or embolisation. The goal of varicocelectomy is to optimise blood flow, decrease vein swelling, and increase the natural functionality of the reproductive organ.

Fertility Treatments: Assisted reproduction technology (ART) can be advised to patient affected with varicocele. If varicocele causes infertility or reduces sperm quality, assisted reproductive procedures such as In vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) may be considered. These techniques aid in the treatment of infertility by directly modifying sperm and eggs.

What to expect in recovery post varicocele treatment?

Here are a few things you can expect during the recovery period after varicocele surgery:

  • The varicocele surgery is performed with modern technology that may take 40-45 minutes.
  • Post varicocele treatment, you will be able to resume work within 2-3 days.
  • The doctor will guide you to change the dressing at home, if necessary.
  • Generally, you are advised to avoid any strenuous activities, heavy weight lifting, and activities that can put pressure on the treated area.
  • You ae advised to take prescribed medication and supplements on time to boost the healing period.
  • Always consult your doctor before resuming work to avoid any complications
  • An expert will advise you to wear a compression undergarment or supporter for the scrotum region, which will help you in recover faster.
  • If you notice any odd sign around the surgical, contact your expert immediately for the right advice to avoid any complications in future.
  • You are advised to abstain from sexual activities for atleast two to three weeks after varicocele surgery.
  • Kepp your body hydrated as it can promote faster recovery.

Risks of Varicocele Treatment

Varicocele treatments need expertise and are typically performed by experts. But like any other surgery, varicocele surgery includes a few potentials risks such as:

  • Infection at the surgical site
  • Recurrence of varicocele
  • Discomfort while functioning day to day activities
  • Damage to nearby veins
  • Excessive bleeding (in rare cases)

How to prevent varicocele?

Varicocele is common condition where veins present in the scrotum becomes enarlged and painful. To restore the quality of life, here are a few tips that can help in preventing varicocele:

  • Wear supporter or compression undergarment when you are doing heavy weight lifting. 
  • Eat healthy diet enriched with vitamins and nutrients. 
  • Drink plenty of fluids and keep your body hydrated. 
  • Wear gears whenever you are playing contact sport to avoid any injury in the scrotum region. 

Questions you ask to an expert regarding varicocele treatment

You can ask the following questions to an expert in order to get better understanding about varicocel treatment:

  • Is varicocele treatment painful?
  • When I can resume playing sports after varicocele treatment?
  • When can I go to gym after varicocele surgery?
  • How much does it take to resume post varicocele treatment?
  • Is varicocele treatment permanent?
  • Can varicocele get cured through medication only?
  • What are the chances of recurrence?
  • How long do I have to stay in hospital for varicocele treatment?
  • When can I resume daily activities post varicocele surgery?
  • What is the recovery period ter varicocele surgery?
  • Should I avoid something specific after varicocele treatment?
  • Is varicocele surgery safe?
  • Are there are any risks associated with varicocele treatment?
  • When can I indulge in sexual activity post varicocele treatment?
  • Can varicocele surgery restore my fertility?

Conclusion

Varicocele is a common disorder characterised by scrotal vein enlargement, which can cause fertility issues or discomfort. Prompt diagnosis and treatment can help relieve symptoms, avoid problems, and enhance reproductive outcomes. To effectively diagnose varicocele, an expert operates a combination of methods like medical history assessments, physical examinations, and diagnostic tests. Hormonal imbalances, hereditary factors, aberrant valve function, and nutritional inadequacies are all potential causes of varicocele. Depending on the severity of symptoms and reproductive concerns, treatment options range from medication to surgical treatments such as varicocelectomy and embolization.

Individuals having any symptoms or fertility concerns should seek immediate medical attention, there are multiple varicocele treatments that can be recommended to restore fertility. Based on the severity of the varicocele condition the expert will determine the tailored varicocele treatment. If you are looking to start a family and want to undergo an effective varicocele treatment, Visit our fertility centre today. You can also book an appointment for a free consultation by calling us on the given number. 

Frequently Asked Questions (FAQs)

  • Is varicocele treatment painful?

Not really, varicocele treatment is performed after giving sedatives that make the whole surgical procedure painless. However, you may have little discomfort post varicocele treatment that can be managed by the prescribed medication. 

  • Can varicocele affect fertility?

Yes. Damaged, blocked, and enlarged veins can affect the blood flow in the scrotum area. Such factors can result in fertility disorders like low sperm count and low sperm quality. 

  • Does varicocele treatment restore fertility?

Yes. During varicocele treatment, an expert removes the affected veins while restoring the blood flow in the testicle sac. This improves sperm quality, structure, and count leading to better fertility health. 

  • Can varicocele make me impotent?

In rare cases, extremely enlarged veins and visible varicocele (grade 3) is associated with a considerable loss in testicular function as well as an increase in serum FSH and LH levels, which may result in erectile dysfunction and male infertility.

Written by:
Dr. Nandini Jain

Dr. Nandini Jain

Consultant
Dr. Nandini Jain is an infertility specialist with over 8 years of experience. With expertise in male and female factor infertility, she's also a published researcher and actively engages in medical conferences on a range of fertility related subjects.
Rewari, Haryana

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