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Varicose veins of the spermatic cord is a condition that affects men and is most often the cause of their infertility. The causes of varicose veins lie in the anatomy – in the abnormal structure of the venous valves. As a result of their malfunction, blood flow is impeded.
What are varicocele?
Varicose veins of the spermatic cord are a condition that affects men (mostly young ones). This is a condition characterized by a twisting of the flagella veins that originate in the veins in the scrotum, which are in the form of soft nodules of various sizes. A vertical, bipedal posture of a human poses the risk of venous stasis. Unfortunately, varicose veins often cause infertility.
Varicose veins – causes
The cause of varicocele is damage to the valves of the testicular veins in the scrotum. This damage occurs as a result of an increased temperature in the scrotum – the blood cannot circulate freely and is not oxygenated. These changes cause sperm to degenerate: the number and ability of sperm to fertilize is reduced. The varicose veins of the spermatic cord begin to appear mainly in the period of sexual maturation. They rarely occur on both sides (usually the left side).
Symptomatic varicose veins can accompany kidney tumors, tumors of the retroperitoneal space, thrombophlebitis. Varicose veins of the spermatic cord can lead to degenerative changes in the area of the testicles.
Varicose veins of the spermatic cord have also been observed in patients suffering from visceral inversion, which is an anatomical determinant of their formation in itself.
Classification of varicocele according to the degree of advancement
We can divide varicose veins according to their degree of advancement. Therefore, we distinguish:
- XNUMXst degree: varicose veins are tiny at first and hardly noticeable, even during the examination. They can be noticed only in a standing position, especially when tightening the abdominal muscles.
- XNUMXnd degree: varicose veins become larger and, although not yet clearly visible, can be located by palpation. When you contract your muscles, they enlarge significantly.
- XNUMXrd degree: varicose veins are visible and large, there is no problem with their diagnosis.
Symptoms of varicocele
As a rule, varicose veins are asymptomatic. However, there are some symptoms that may indicate the presence of this condition, including:
- groin pain
- testicular pain
- a feeling of heaviness in the scrotum,
- pain felt during an erection,
- feeling very warm in the scrotum
- slight swelling of the scrotum
- sometimes damage to the testicle (by large varicose veins).
Diagnostics of varicocele
In the diagnosis of varicocele, the most common method is self-examination, which is called palpation in the standing position with the Valsalva maneuver. During it, the patient must increase the exhalation while closing his mouth, it is the so-called pressure. Thanks to this method, the specialist is able to assess the advancement level of varicocele.
In addition to this method, ultrasound is also used, in which the flow in the vessels is analyzed.
Very often men who are treated for infertility find out about having varicocele during the examination. Research shows that the presence of this condition is responsible for up to 40% of infertility cases. The number of sperm produced decreases when there is an increase in temperature and increased blood flow.
Doctors during the examination advise men to check the quality of their sperm. Many of them wonder where the idea came from. The quality of the semen helps to choose the right treatment method, but it is also helpful in assessing the effect of the treatment. In a situation where varicose veins are not painful, men are only supposed to observe whether they are enlarging. However, when varicose veins are accompanied by pain and the man wants to start a family – surgery is necessary.
In men in the period of sexual maturation, the indication for the surgical procedure of varicocele is the inhibition of the growth of the testicle size on the side of the varicose veins.
Treatment of varicocele
Treatment of varicocele is operative and consists in retroperitoneal ligation of the nuclear vein or its embolization. This method relieves pain and improves spermiogram results.
The procedure is performed either under local or general anesthesia (narcosis), or using the laparoscopic method. During the operation, the surgeon searches for the vessels to ligate them, it takes less than half an hour, and hospitalization lasts 1-2 days on average. Pills after the procedure are helped by tablets or ice packs. Men recover to full fitness very quickly after the procedure, it takes about two weeks. Also after this period, intercourse can be started again.
Very rarely, and relapses occur only when there were a lot of changes and it was not possible to close them all.
Another method of fighting varicose veins is embolization, which is a minimally invasive method performed by interventional radiologists under local anesthesia. By puncturing the groin, the radiologist has access to the femoral vein, in which he places a catheter that goes to the nuclear vein. First, the contrast is administered, and the flow in the veins is assessed by X-ray. Subsequently, a sclerosing agent is administered through the catheter and / or special embolizing coils are introduced into the vein in order to close the flow in the vessel. The advantage of this procedure is certainly faster convalescence and local anesthesia instead of anesthesia.
Effectiveness of surgery for varicocele
The treatment of varicocele during the surgery has a positive effect on the mobility, quality and number of sperm. To see the first results (in the form of better test results), you need to wait about 3 months, because this is how long it takes for a new sperm to develop. It happens that the number of sperm does not increase dramatically, but the quality of the sperm cells improves, which in turn gives a greater chance of success in e.g. artificial insemination.
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