Caused by abnormally dilated, swollen veins in the scrotum, varicoceles are often associated with infertility.
Occurring in one to two men out of ten, varicoceles are not uncommon. A swelling or mass develops above the scrotum itself, and can feel somewhat similar to a bag of worms. The swollen veins do not have adequate valves. Many men are not aware they have this condition.
There are some common factors manifested in men with varicoceles, including:
Large veins connecting the heart and testicles have different configurations for the left testicle. The different connection requires additional pressure from the left side to pump blood through the abdomen to the heart. This may explain why varicoceles occur primarily in the left testicle.
Chemicals from the adrenal gland, sitting near the top of the main testicular vein, may adversely affect the testicles ability to produce sperm and testosterone.
Blood pumped toward the heart may become sluggish and flow back, or pool, causing swelling in the veins.
Inadequate valves exist within the veins in the scrotum.
Warmer blood flowing from the abdomen raises the body temperature in the left testicle beyond the optimal point to produce sperm and testosterone.
Occasionally, abnormal posterior abdominal masses or swollen lymph nodes interrupt the normal flow of blood. In these instances, sudden and painful swelling develops in the scrotal veins.
Indicators of varicoceles include:
Impaired sperm count affecting fertility
Decreased levels of testosterone
Scrotal pain or discomfort
Ejaculation lacking sperm
Abnormal development of the testicles
Shrinking of testicles
The patient or his physician discovers varicoceles while feeling the scrotum during a regular exam. Varicoceles feel and appear similar to a bag of wet spaghetti.
Checking suspected varicoceles with the patient standing allows discovery when veins are too small for discovery in a reclined position. A scrotal ultrasound also helps in discovering varicoceles.
How Is It Performed?
Performing varicocelectomy surgery to treat male infertility is common. When recommending surgical intervention, one of two methods is typically used. Microsurgical varicocelectomy performed via a subinguinal or inguinal incision is the gold standard for surgical techniques. Minimal complications occur during or after this 60-minute procedure.
Not only the most common way to correct male infertility, varicocelectomy surgery addresses or repairs low testosterone levels, shrinking testicles, scrotal pain, and defective DNA quality of sperm.
While peering through a very powerful microscope the surgeon makes an incision at the subinguinal or inguinal site. Subinguinal incisions is the preferred surgical technique for some surgeons. Inguinal incision techniques may be necessary with men who have had previous subinguinal surgeries.