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Varicoceles

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A varicocele is a swollen varicose vein that occurs in the scrotum, the tissue holding up a man’s testicles. Sometimes the varicose cluster will appear as a lump of tangled varicose veins underneath the skin of the scrotum. However, in some patients, the swollen veins may also develop deeper inside. Men can be affected at any age, although many varicoceles develop during puberty. Studies suggest that overweight or obese men also have a higher chance of developing a varicocele.

Varicocele symptoms include swelling, pain, and infertility. A varicocele causes lower sperm count and poorer quality sperm. Damage from a varicocele can also make the testicles soften and shrink. If a varicocele is causing neither pain nor infertility, then medical treatment is not always necessary. In fact, the majority of varicocele cases results in little to no symptoms at all. In the rare cases in which pain is present, the patient may feel a kind of heaviness in the genital region that increases whenever he sits, stands, or exerts himself for any extended period of time. Over time, if the varicocele gets bigger, these symptoms may worsen. It is important to see a doctor when patients notice a varicocele, as testicular masses can be a sign of cancerous tumors or other serious health conditions. After a varicocele is diagnosed, however, patients will be able to choose to either leave it alone until symptoms appear or to move forward with varicocele repair treatments.

A singular cause of varicoceles has yet to be determined, although experts think problems with venous valve function in the spermatic cord may cause improper blood flow.  Such improper blood flow, in turn, results in vein swelling. This theory is supported by the fact that most varicoceles occur on the left testicles, where the largest testicular vein is located. However, the presence of a varicocele and infertility problems are rarely isolated to only one testicle. Infertility triggered by a varicocele usually affects the entire reproductive system.  Sometimes a varicocele can even make the patient completely sterile.

Before resorting to alternative methods of reproduction such as artificial insemination, in vitro fertilization, or introcytoplasmic sperm injection, patients with a varicocele should get treatment for their swollen veins. Varicocele treatment is available with varicocele embolization or varicocele surgery. The former is a non-invasive technique that involves blocking off the veins that supply a varicocele cluster.  This forces the varicocele to atrophy, or disappear, and can improve symptoms. In the case that a more invasive approach is necessary, patients may also undergo open surgery with a varicocelectomy or minimally invasive surgery with a laparoscopic varicocelectomy.

Contact a doctor listed in our directory if you think you may have varicocele.

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