Varicocele, (Scrotal Varicose Vein) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

A varicocele is a medical disorder that results from the abnormal dilatation of the pampiniform venous plexus and the internal spermatic vein caused by venous reflux.
Varicocele is a well-known cause of reduced testicular function and occurs in about 15-20% of all males and in 40% of infertile males.
A varicocele is a varicose vein of the scrotum and testicle.
In a varicocele, the valves in the veins of the pampiniform venous plexus do not function properly.
Varicoceles can impair sperm production and function.
They are important because they are a well-recognized cause of reduced testicular function and are linked with male infertility.
If left untreated, varicoceles may lead to infertility.
A varicocele forms when valves inside the veins that run along the spermatic cord prevent blood from flowing properly.
This causes the blood to back up resulting in widening and swelling of the veins.
Varicoceles are more common on the left for anatomical reasons:

1. The angle at which the left testicular vein enters the left renal vein.
2. Inadequate effective valves between the testicular and renal veins.
3. The increased renal vein pressure due to its compression between the superior mesenteric artery and the aorta (i.e., nutcracker effect).
   Varicoceles differ in size and can be categorized into the following 3 groups:
   a. Large - Easily identified by inspection alone
   b. Moderate - Identified by palpation without bearing down (Valsalva maneuver)
   c. Small - Identified only by bearing down which raises intra-abdominal pressure thus impeding drainage and raising varicocele size
   They are more common in men ages 15 - 25 and are most often seen on the left side of the scrotum.
   Symptoms are:
4. Enlarged, twisted veins in the scrotum
   It has been described as a bag of worms.
5. Painless testicle lump, scrotal swelling, or bulge in the scrotum
   Physical examination is not the best method of detection
   Doppler studies is the method of choice to diagnose varicocele
   CT scans - may be required to identify tumors obstructing the testicular vein.
   Infertility is a complication of varicocele
   Treatment is by:
6. A jock strap (scrotal support) or snug underwear may help relieve the pain or discomfort.
   If pain persists or other symptoms happen, the patient may need further treatment.
7. Surgery to correct a varicocele is called varicocelectomy.
   The patient will leave the hospital on the same day as the surgery.
   During this procedure, the patient will receive some form of anesthesia (numbing medication).
   The urologist will make a cut usually in the lower abdomen and ligate the abnormal veins.
   Blood will now circulate the area into normal veins.
   Keep an ice pack on the area for the first 1 day after surgery to decrease the swelling.
8. An alternative to surgery is varicocele embolization.
   TABLE OF CONTENT
   Introduction
   Chapter 1 Varicocele
   Chapter 2 Causes
   Chapter 3 Symptoms
   Chapter 4 Diagnosis
   Chapter 5 Treatment
   Chapter 6 Prognosis
   Chapter 7 Infertility
   Chapter 8 Male Orgasm
   Epilogue

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