Varicocele is a condition in which the veins in the testicles swell or expand. This can result in the testicles producing less sperm and having poor sperm quality. It can also lead to infertility or cause the testicles to shrink. However, most patients may have symptoms that gradually improve on their own without needing treatment. However, if symptoms persist, patients may undergo surgery.
Symptoms of varicose veins of the testicles
Varicocele patients often have no symptoms, so some people may not know they have the condition until they are diagnosed by a doctor. However, those who do have symptoms may notice the following:
- There is a lump in one testicle, and one testicle may be smaller than the other.
- The veins in the testicles are dilated, twisted, or worm-like.
- Swollen testicles or a dull ache inside
- The pain is worse when sitting, standing, or exercising for long periods of time, but improves when lying down.
- Symptoms get worse during the day
Varicocele is more common in the left testicle because the structure and placement of blood vessels in each testicle are different. The left testicle is more prone to varicocele than the right testicle. However, in some cases, varicose veins can occur in both testicles at the same time, although this is less common.
Causes of varicose veins of the testicles
Currently, doctors do not know the exact cause of this condition, but it is expected that it may be caused by the valves in the veins, which transport blood in one direction, malfunctioning and not working properly. This causes the blood to not flow in the normal direction and pools in the veins in the testicles, causing the veins in that area to expand. This condition is common in people aged 15-25 years. In addition, elderly patients who have a tumor in the kidney suddenly may be at risk of developing Varicocele because the tumor blocks the blood flow to the veins.
Diagnosis of varicose veins of the testicles
The doctor will perform a physical examination by feeling the testicles for any abnormal lumps or veins. If no abnormalities are found, the doctor may have the patient stand up, hold their breath, and push air into their abdomen. This method will help to see the enlargement of the veins more clearly. The doctor may then perform an ultrasound of the testicles to check for abnormalities in the internal structures of the testicles and surrounding areas . The doctor will also determine the size of the varicose veins in the testicles to help with the diagnosis, with grade 1 being the smallest and grade 3 being the largest.
Treatment of varicose veins of the testicles
Varicocele patients may not require treatment, but if they experience pain, testicular atrophy, or infertility, the doctor may initially recommend painkillers and underwear that support the testicles to help relieve pain. In addition, patients may undergo surgery if they experience pain or infertility that requires treatment. The doctor will perform surgery to treat the veins in the testicles to redirect the blood flow in the proper direction. The doctor may recommend various surgical methods based on the appropriateness of each patient, depending on the severity of the varicocele or the patient’s health condition, such as open surgery, which uses medical equipment to operate directly on the testicles to correct abnormalities in the blood vessels in that area, and endoscopic surgery, in which the doctor may put the patient under general anesthesia and make a small hole in the abdomen to insert a camera and send medical equipment into the abdomen to operate, including occlusion treatment, in which the doctor inserts a balloon or coil into the varicose veins of the testicles to stop the blood flow, causing the blood vessels to collapse, etc. However, after surgery, patients may experience recurrence and infection in the surgical wound. The balloon or coil inside the blood vessel may also move.
For patients who undergo surgery, they may return to work 1-2 days after surgery, but should avoid exercising for about 2 weeks. If there is pain after surgery, the doctor may recommend taking paracetamol or ibuprofen to relieve the symptoms. For patients who undergo surgery to treat infertility, the doctor will make an appointment to see the symptoms in 3-4 months to check the growth of sperm . The changes may be seen in the next 6-12 months. These treatments help almost half of infertility patients to improve their symptoms.
Complications of varicose veins of the testicles
Varicocele may cause the following complications:
- Varicocele may cause the testicles to atrophy and soften. Although the cause of the atrophy is still unclear, it may be due to abnormal functioning of the valves in the veins, causing blood to flow back into the veins, or blood entering the veins but cannot flow further, resulting in high pressure in the veins and an increased risk of exposure to toxins that come with the blood. The testicles may therefore be more damaged.
- Infertility Varicocele can cause the area around the testicles to become hotter, which can affect sperm production, sperm motility, and sperm quality.
- Other complications include blood clots,infection, injury to the testicle or nearby blood vessels, etc.
Prevention of varicose veins of the testicles
Since the exact cause of Varicocele is still unknown, there is no definite way to prevent it. This condition often does not show any symptoms in the early stages. Therefore, you can reduce the risk by observing your symptoms and getting an annual health check-up to be aware of any abnormalities that may occur. If you have symptoms that you suspect may be caused by this condition, you should see a doctor to get an early diagnosis and treatmen
