Varicocele is a common condition in men where veins in the testicle region become enlarged and may cause infertility or testicular atrophy. Treatment options include open surgery or newer methods like varicocele embolization.
A varicocele is similar to a varicose vein, but only occurs in men in the testicle region, usually above the left testicle. It is quite common and occurs in over 10% of men, often appearing in adolescence or early adulthood. It is essentially an enlargement of one or more veins of the pampiniform plexus, which drain blood from the testicles. Research suggests that developing these enlarged veins could be due to slight abnormalities in how the veins work.
There may be few symptoms of a varicocele except a noticeable enlargement or bump that is clearly an enlarged vein. When mashed, it’s usually not tender and feels a bit hard. However, it is possible for the varicocele to get bigger. They can also sometimes cause pain, especially when sitting for long periods of time or if a person spends a day doing heavy labor or straining.
A possible complication of this condition is that it can produce infertility in some men, and an examination of the causes of infertility would include making sure a man does not have a varicocele. Another potential complication of an untreated varicocele is testicular atrophy (shrinkage) of one testicle. These complications do not always occur and treatment of this condition may only be indicated when they occur or if the varicocele is very large and/or causing pain.
Several methods can be employed to remove a varicocele. These include a few different open surgical techniques, which are often the most common repair methods. Surgeons may work from an incision in the abdomen or below the groin while a patient is under anesthesia (often local or conscious sedation). The dilated veins are located and removed (tied or cut). Open surgical techniques are often performed as an outpatient surgery and tend to be very successful. Men undergoing these surgeries may need to spend a few weeks recovering before resuming normal activities and may not be able to do any heavy lifting for about 6 weeks.
Other methods of removing a varicocele may include those using laparoscopy, although this is not a common method in many countries. Another option is called varicocele embolization, which is relatively new and can sometimes be dismissed as a poor option. This uses catheterization to block off a vein so that the enlarged veins disappear. Studies on this method suggest it can be extremely effective and has the benefit of fast recovery times. However, many doctors believe that open surgery is the best option, but medical opinion on the most successful treatment is certainly subject to change.
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