Varicocele Treatment in Delhi, India

Varicocele is a condition where the veins in the scrotum are enlarged or swollen. These usually develop due to abnormalities in the veins of the scrotum.

Associated Anatomy of Varicocele

Scrotum

Varicocele Causes

The scrotum of the males is the skin pouch that holds the testicles and their supportive structures. The structures that emerge from the testicles are called spermatic cords. These spermatic cords consist of the blood vessels that supply blood to and from the testicles and the ejaculatory ducts that carry the sperm from the testicles to the ejaculation duct.

The blood vessels, specifically veins of the scrotum, may become abnormally enlarged due to blood pooling, resulting in a varicocele. The reasons behind this enlargement or swelling are not known. Certain reasons have been offered, such as:

• Poor circulation in the spermatic cord due to poorly functioning veins
• Possible backflow of blood in the veins
• Sluggish movement of blood resulting in accumulation.

Varicocele Symptoms

In most cases, men who develop varicoceles face no symptoms at all. Varicoceles are painless in most cases. Some symptoms include:

• Development of dull pain in the testicular areas
• Discomfort in the scrotal area while sitting down
• A feeling of heaviness in the scrotum, almost like dragging
• Dilated veins that are visible and can be felt. The sensation reported is “worm-like”.

The abnormal difference in the size of the testicles due to difference in blood flow.

Stages of Varicocele

Depending on the diagnosing characteristics, the varicocele is assigned a particular grade.

• Grade 1: Varicocele that is detected only on imaging such as ultrasound, not physically palpable.
• Grade 2: Varicocele that is palpable only when the patient is Valsalva manoeuvre.
• Grade 3: Varicocele that is physically palpable regardless of the patient’s position
• Grade 4: Varicocele that causes visual deformity in the scrotum.

Varicocele Diagnosis

Varicoceles are physically visible, hence are diagnosed through visual examinations. Smaller varicoceles can be diagnosed by physical exams where the doctor will ask you to “bear down” the testicles to diagnose varicoceles that are not visible. They may also require scrotal ultrasounds if the varicoceles are even smaller.

Differential Diagnosis of Varicocele

The differential diagnosis for a varicocele is the physical palpability of the varicocele coupled with the ultrasound.

Varicocele Treatment

• Unless varicoceles cause any problems, they don’t need to be treated.
• The urologist may recommend surgery that clips off the veins causing the varicocele to boost sperm movement for men who are having trouble with fertility due to the varicoceles. However, if the varicoceles do not negatively impact your life, the surgery can be avoided.
• Any OTC pain killer medications can be used for pain due to varicoceles.
• Home remedies are also recommended, such as ice packs and routine changes in clothing options such as tighter underwear to prevent jostling of the scrotum.

Risk Factors of Varicocele

There are no known causes as to why the development of varicoceles takes place. Due to this reason, no particular risk factors have been identified. However, statistics suggest that boys going through puberty are more likely to develop varicoceles than adult men. This is because the body undergoes a major growth spurt; hence the demand for blood supply is higher, which may cause irregular blood flow to the testis, resulting in a varicocele.

Possible Complications of Varicocele

Varicoceles may negatively impact the fertility of some men due to obstructed blood flow to the testicles or obstructed sperm flow to the penis. This is the most common complication of varicoceles. However, it is easily treatable through surgeries where the doctors eliminate the varicoceles by cutting the enlarged veins.

Varicocele Preventions

Primary Prevention of Varicocele

• Avoid prolonged standing.
• Avoid constipation.
• Avoid heavy weight lifting.

The cause of a varicocele is not clear yet; due to this reason, there are no prevention strategies that can be formulated to prevent the development of a varicocele.

Secondary Prevention of Varicocele

There are no known causes of a varicocele. Hence, it is not possible to prevent the reoccurrence of a varicocele.

Epidemiology of Varicocele

Very little is known about the causes behind a varicocele. However, it has been observed that boys undergoing puberty are more likely to develop a varicocele than adults due to the growth spurts.

Expected Prognosis of Varicocele

Varicoceles are not life-threatening and, in most cases, painless. Hence, men who have developed varicoceles can expect a healthy life even with the varicocele intact. In case it affects their fertility, urologists suggest surgery that can get rid of the varicocele, and in such cases, the males can expect their fertility to improve after the surgery by around 40-50%.

Natural Progression of Varicocele

The natural progression of an untreated varicocele is not life-threatening; varicoceles are not fatal and can allow you to live a healthy and normal life if they are painless or manageable with painkillers.

Pathophysiology of Varicocele

The scrotum of the males is the skin pouch that holds the testicles and their supportive structures. The structures that emerge from the testicles are called spermatic cords. These spermatic cords consist of the blood vessels that supply blood to and from the testicles and the ejaculatory ducts that carry the sperm from the testicles to the penis. The blood vessels, specifically veins of the scrotum, may become abnormally enlarged due to blood pooling, resulting in a varicocele.