Varicocele occurs when the network of veins that leave the testis (pampiniform plexus) become elongated and enlarged. The valves within the pampiniform plexus when they work properly only allow the blood to flow away from the testicle - if there is something wrong with them, blood builds up.
Approximately 15% of men have a varicocele. A varicocele develops over time.
The network of veins often appear visibly blue through the scrotum and feel like "a bag of worms". When the patient lies down symptoms are less evident.
Varicose veins people get in their legs are similar to a varicocele.
Varicoceles can lower a man's sperm count and undermine the quality of his sperm. In some cases, the testicles may shrink.
A symptom is something the patient feels and describes, such as pain, while a sign is something the doctor, nurse or somebody else detects, such as an irregular heartbeat.It is common for the patient to experience no signs or symptoms at all. In some cases there may be pain, which can.. ..be dull or sharp. There may be a sensation of heaviness. Some describe it as a dragging-like pain...worsen when the patient is physically exerting himself, standing or sitting. Prolonged periods of exertion are more likely to bring on pain...get worse later on during the day..feel better when the patient is lying downEventually most varicoceles grow and the person becomes more aware of them. Often described as feeling "like a bag of worms". The valves in the veins that go along the spermatic cord do not work properly, a similar process as varicose veins in the legs. A defect in the valves leads to a backflow of blood into the pampiniform plexus, raising pressure there and causing the veins to dilate, and eventually damaging testicular tissue.
Most varicoceles occur on the left side, where the left-testicular vein is.
During a physical exam the GP (general practitioner, primary care physician) may be able to feel the mass of veins, or the bag of worms. In cases were signs are not evident, the doctor may ask the patient to do a Valsalva maneuver - take a deep breath, hold it and bear down.If the doctor is still not sure, a scrotal ultrasound may be ordered, this will show whether the veins in the pampiniform plexus are greater than 2mm.
The doctor may recommend not treating the varicocele. If there is pain, the testicle is shrinking, or the patient's sperm count and quality is affected something will have to be done. Surgery may be performed to seal off the dilated vein so that blood can flow through healthy veins. This may not always solve the sperm count and quality problem, though.If surgery is needed the patient does not usually have to stay in hospital afterwards. Post-operative pain is generally mild.
To test sperm count and quality the patient will have to wait a few months after the operation for a semen analysis.
Testicular atrophy (testicle shrinkage) - if the sperm-producing tubules are damaged, the testicle will get smaller and softer.Sperm count and quality - there is a risk the man may become infertile, or find it much harder to get a woman pregnant. Experts say that the temperature inside the testicle sometimes rises if there is a varicocele, affecting sperm production and motility.
Written by Christian Nordqvist
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