Varicoceles are varicose veins in the testicles: For many men, the condition is a taboo subject - yet this varicose vein rupture is widespread and may get in the way of an existing desire to have children. It is therefore important for men to know everything they need to know about the topic and to be prepared in the event of an emergency. Find out more here and find selected specialists for varicoceles.
Varicoceles are varicose veins that occur in the scrotum. Doctors also refer to the condition as "varicose vein hernia". "Varico" stands for varicose veins, "zele" for protrusion/rupture. However, varicocele is not a rupture in the true sense of the word, but rather an enlargement of the venous plexus that runs along the spermatic cord. Blood flows through this, which in some men accumulates due to various causes.
This leads to blood congestion in the venous plexus. The clinical picture is therefore similar to varicose veins in the legs. The medical term for this plexus of veins in the scrotum is pampiniform plexus.
According to the current state of research, doctors differentiate between varicoceles according to how pronounced and easily recognizable they are. They also differentiate between left-sided, right-sided and bilateral varicoceles. However, they are most frequently localized on the left side (90%), less frequently on the right (7%) and very rarely on both sides (3%).
Those suffering from mild varicoceles often feel no pain or other symptoms. In this case, the disease is often only an incidental finding.
Advanced varicoceles, on the other hand, are recognizable as worm-like growths that can be felt under the skin of the scrotum. They are particularly visible when those affected tense their abdominal muscles. The reason for this is the increase in pressure in the abdominal cavity caused by tensing the abdominal muscles, which impairs venous drainage and causes blood to back up.
Some patients also suffer from
Varicoceles in children and adolescents are often noticeable as smaller testicles. The background: the disease inhibits testicular growth.
Varicoceles may be a taboo subject, but they occur frequently - around 15 percent of all men have or have had a varicose vein in the testicles. Statistically, they occur most frequently in young men during puberty, with the peak age being between 15 and 25 years. However, varicoceles can also occur in children.
However, most patients only notice them in adulthood, as they rarely cause symptoms in the early stages. This makes it all the more important to carry out further examinations if varicoceles are suspected and to arrange a consultation with a urologist, if necessary, in order to avoid consequential damage. The most serious consequence is certainly infertility due to a maturation disorder of the testicles.
Doctors differentiate between primary (idiopathic) varicocele and secondary (symptomatic) varicocele. They have different underlying causes.
The primary varicocele is congenital and occurs more frequently in tall, slim men.
It is often caused by a defective venous valve in the testicular vein or a weakness in the vascular wall. A venous outflow disorder due to increased vascular pressure is also a possible cause of the primary form of varicose vein hernia.
he secondary form of the disease is not congenital, but acquired. It occasionally occurs on both sides and is caused, for example, by tumor-related blood stasis. These include tumors of the kidney, renal pelvis or ureter. In rare cases, varicoceles in the testicles are caused by a thrombus (blood clot) or a rupture (tear) in the veins.
Researchers and doctors suspect that varicoceles can have a negative impact on male fertility . Studies show: Men with low fertility are more likely to suffer from varicoceles than fertile men. It is estimated that 25 percent of men with impaired fertility have varicoceles.
However, fertility is by no means ruled out by the condition. There are men who are able to conceive normally even though they suffer from varicoceles. However, if you wish to have children, you should consult a urologist (specialist for diseases of the kidneys, urinary tract and male reproductive organs) and clarify the treatment options.
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If it is a large varicocele, it is already visible and palpable on the outside. It sometimes disappears when lying down, but is usually easy to examine and visualize in a standing patient.
However, smaller varicocele are sometimes not immediately recognizable, especially in the early stages. In such cases, the use of an ultrasound device (sonography device) is necessary. This allows the disease to be diagnosed, although further tests may be necessary if the doctor deems them useful.
For example, a spermiogram (analysis of the ejaculate) is recommended for men who wish to have children. This provides further information on fertility. If there are any abnormalities here, this may be due to a varicocele. Nevertheless, a blood sample should be taken to test hormone levels - for example the sex hormone testosterone - to rule out other causes of infertility.
Treatment of varicocele is possible in principle, but not always necessary. Varicoceles often disappear spontaneously over time. Treatment is advisable if there is a desire to have children or if the patient suffers from severe symptoms such as pain.
The treatment usually involves stopping the congested veins. This allows the blood to flow through healthy veins that are adjacent to the diseased vein. The treatment is carried out either by
In order to close or obliterate the affected vein, the treating doctor injects a medication into the testicular vein.
In the case of varicoceles with a secondary cause, it is necessary to eliminate the actual trigger. Depending on the cause, this can be done with suitable tumor therapy, for example.
Anyone suffering from a varicocele probably prefers the gentler procedure of sclerotherapy. However, this is not possible for all patients. It is therefore decided on an individual basis which treatment is feasible and advisable.
In the conventional surgical method, the vein is cut through a small incision in the groin or on the side of the abdomen. In addition, laparoscopic surgery, i.e. using the keyhole technique, can be performed in the testicles or abdomen and the varicose veins in the testicles and the veins feeding them can be cut(varicocelectomy). This relieves the blood congestion and the blood flows out again through other, healthy veins.
Varicoceles are usually easy to treat. The chances of recovery after medical intervention are high. The earlier the treatment begins, the easier it is in principle to dissolve or clamp off the blood congestion in the testicular vein. It is therefore advisable to consult a doctor immediately if symptoms occur or a palpable growth is detected. The aim of treatment is to reduce pain and improve semen quality. The treatment also aims to achieve a normal hormonal balance.
Testicular varicose veins are certainly not pleasant once they cause discomfort. Anyone suffering from pain or a feeling of pressure in the testicle area should therefore consult a urologist straight away. This applies in particular to men whose family planning has not yet been completed. With the right treatment, the normal condition is usually restored within a short time, so there is no need to fear any consequential damage.
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