Varicocele is a varicose vein in the spermatic cord and testis.
The name “varicocele” comes from a combination of 2 words: the Latin word varix, which means “venous node” and the Greek word kele – swelling, swelling, and all together means “swelling of the venous nodes.” This is one of the most common diseases – it is present in 10-15 percent of all men. Moreover, if we take all men with infertility, then varicocele is detected in 40 percent of them. Moreover, if we single out a group of men with so-called secondary infertility (that is, those men from whom women have previously become pregnant, but who cannot currently become fathers), it turns out that varicocele occurs in 80 percent of such men.
By itself, varicose veins of the spermatic cord are not a big problem, the patient’s life is not threatened, and you can live with him calmly all your life without much concern. The main complication of this disease is male infertility.
It develops for the following reasons. Through the veins of the scrotum, blood flows from the testicle and surrounding tissues towards the heart. In this case, the blood flows from the bottom up, against gravity. Normally, a special valve system of the venous wall prevents the reverse flow of blood through the veins. When the veins expand, these valves stop working, as a result of which the blood begins to make the so-called “pendulum-like movements” in the vein. As a result, the blood supply to the testicle as a whole suffers. The venous network within the testicle becomes larger and larger, and in pronounced cases the testicle is, as it were, immersed in a sponge of venous vessels. Such a blood “cushion” from the venous vessels within the testicle leads to the fact that it ceases to cool. But for the production of spermatozoa, a lower temperature is needed – between 32.5 and 34.5C, which means that with varicocele, sperm production stops. That is why varicocele is one of the main factors of male infertility.
In addition, due to the peculiarities of testicular tissues with varicocele, the so-called aseptic autoimmune inflammation can develop in it. And it is expressed the stronger, the better the immunity of the body of a man is.
As a rule, varicocele occurs only on one side – on the left, bilateral varicocele is not common and quite an exceptional case – right-sided varicocele. This is due to the different position of the testicular veins on the right and left. Sometimes the disease makes itself felt in the form of pain in the testicles. They occur due to blood pressure on the wall of the venous plexus. Pain, as a rule, is not very strong and is bursting or pulling in nature.
If the enlargement of the veins is significant, and the diagnosis leaves no doubt, then an additional examination is not required. Otherwise, dopplerography of the vessels of the scrotum and duplex scanning will be necessary.
For the treatment of varicocele, only surgical methods are used, no medical therapy in this case will help. But the doctor leaves the decision to carry out the operation to the man himself. This disease does not affect sexual activity, and therefore an operation is necessary if we are talking about a young man who has yet to start a family. However, an older man may not need surgery if he no longer plans to have babies.