Chapter 1
Varicocele
What is a varicocele?
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.
What is the cause of a varicocele?
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.
This is essentially the same process that leads to varicose veins which are frequent in the legs.
A varicocele forms when valves inside the veins that run along the spermatic cord prevent blood from flowing properly.
The blood backups leading to swelling and widening of the veins.
Varicoceles develop slowly most of the time.
The problem is more common on the left side than the right.
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).
This is sometimes called aorto-left renal vein entrapment syndrome
A one-sided varicocele can often affect the opposite testicle.
Up to 35-40% of men with a palpable left varicocele may actually have bilateral varicoceles that are found upon examination.
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
In a varicocele, these valves do not work properly, resulting in blood to collect widening the vein.
Some doctors believe that the raised temperature that occurs from the collected blood in these obstructed veins can reduce sperm count and sperm motility and raise the number of deformed sperm.
Varicoceles normally develop slowly.
They are more common in men ages 15 - 25 and are most often seen on the left side of the scrotum.
It is unusual in boys under the age of 10 years.
Incidence increases after puberty.
The prevalence is 15% of the general population and is the same in adults and adolescents.
Varicocele has been indicated as a factor in 35-50% of patients with primary infertility and up to 81% of men with secondary infertility.
The sudden occurrence of a varicocele in an older male may be due to a kidney tumor which can block blood flow to a vein.
This is more frequent on the left side than the right.
What are the symptoms of a varicocele?
It is normally asymptomatic (between 2% and 10% have symptoms) and only rarely induces pain.
The scrotum with varicoceles is often observed as heavy 'like a bag of worms'.
It may be an incidental sign, observed at routine medical examinations or noted in children by their parents.
1. Enlarged, twisted veins in the scrotum
It has been described as a bag of worms.
2. Painless testicle lump, scrotal swelling, or bulge in the scrotum
TABLE OF CONTENT
Introduction
Chapter 1 Varicocele
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Pro
Varicocele
What is a varicocele?
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.
What is the cause of a varicocele?
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.
This is essentially the same process that leads to varicose veins which are frequent in the legs.
A varicocele forms when valves inside the veins that run along the spermatic cord prevent blood from flowing properly.
The blood backups leading to swelling and widening of the veins.
Varicoceles develop slowly most of the time.
The problem is more common on the left side than the right.
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).
This is sometimes called aorto-left renal vein entrapment syndrome
A one-sided varicocele can often affect the opposite testicle.
Up to 35-40% of men with a palpable left varicocele may actually have bilateral varicoceles that are found upon examination.
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
In a varicocele, these valves do not work properly, resulting in blood to collect widening the vein.
Some doctors believe that the raised temperature that occurs from the collected blood in these obstructed veins can reduce sperm count and sperm motility and raise the number of deformed sperm.
Varicoceles normally develop slowly.
They are more common in men ages 15 - 25 and are most often seen on the left side of the scrotum.
It is unusual in boys under the age of 10 years.
Incidence increases after puberty.
The prevalence is 15% of the general population and is the same in adults and adolescents.
Varicocele has been indicated as a factor in 35-50% of patients with primary infertility and up to 81% of men with secondary infertility.
The sudden occurrence of a varicocele in an older male may be due to a kidney tumor which can block blood flow to a vein.
This is more frequent on the left side than the right.
What are the symptoms of a varicocele?
It is normally asymptomatic (between 2% and 10% have symptoms) and only rarely induces pain.
The scrotum with varicoceles is often observed as heavy 'like a bag of worms'.
It may be an incidental sign, observed at routine medical examinations or noted in children by their parents.
1. Enlarged, twisted veins in the scrotum
It has been described as a bag of worms.
2. Painless testicle lump, scrotal swelling, or bulge in the scrotum
TABLE OF CONTENT
Introduction
Chapter 1 Varicocele
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Pro
