Varicocele

Varicocele

What is varicocele?

Varicocele is tortuous dilation of veins (Pampiniform plexus) carrying the blood from testis to the heart.

Why does varicocele occur?

Normally the flow of blood in and out of the testis is unidirectional. The blood from the heart travels to testis in high pressure equivalent to an individual’s blood pressure ie 120/80 mm of Mercury. Moreover the flow is in the direction of gravitational pull, so it’s effortless. The blood from the Testis to heart has to be carried against gravity and it is under low pressure which is 15-20/0 mm of Mercury. Now when the heart beats the blood is pushed up as that time the pressure is 15. When the heart relaxes there is a tendency for this blood to flow back to Testis due to gravitational pull. However, this is prevented by valves that are inside the vein.

Since there is backflow of blood, the veins gets congested, dilated and tortuous due to pooling of blood.

God has put all the organs of body like liver, kidney, intestine etc inside the abdominal cavity. However, the testis are lying and hanging outside the body in a sac called scrotum. The purpose is to keep the testis cooler than rest of body. The temperature of testis is 36 degree whereas the normal body temperature is 37 degrees. This lower temperature is essential for production of good quality sperms (Spermatogenesis). If the temperature of testis remains high as in case of varicocele due to pooling of blood, the quality of sperms go down and in long term even permanent damage to testis can happen.

How is varicocele treated?

Since varicocele is a mechanical problem, the solution is also mechanical. No medicines can cure this problem. Treatment involves ligating the dilated veins effectively preventing the retrograde flow of blood.

 Options are:

1. Laparoscopic varicocelectomy
2. Inguinal varicocelectomy
3. Subinguinal microscopic varicocelectomy

The last option is the treatment of choice. A small around 2 cm cut is made just by side of root of penis and all dilated veins are identified and ligated through this incision. It is a day care procedure. Patient can go home the same day and start work after 1 day rest. After surgery heavy work is avoided for 2 weeks. Thereafter absolutely normal life can be resumed.

How do I know that I have varicocele?

1. The side where you have varicocele will hang lower than the opposite side.
2. You may feel a bunch of tissue behind the testis. It feels like a bag with worms in it.
3. There can be persistent pain in the testis.
4. The testis may become smaller than the opposite normal testis.
5. The semen analysis may show low sperm count.

What if I don’t get treatment?

In long term varicocele can cause permanent damage to the sperm producing cells of the testis. If that happens it may render a male infertile.

If you are happy with your visit and are getting better please write a review: You can google drsumiturologist or Deetyaclinic: there will be a business page towards right side. Please write a review and help us grow.