Varicocele - Varicocele is the enlargement of the veins, scrotum and spermatic cords which mainly occurs on the left side. Varicocele (varix dilatation) is mainly detected in the young people and sometimes doesn’t cause anxiety and is found during usual examination.

However, varicocele causes pains during sexual intercourse and serious concern like weakening of sexual activity and decrease of reproductive functions.

Causes:

• One of main causes is congenital weakness of venous wall and valve. Due to hereditary nature genetic inclination is observed towards such pathology (varix dilatation, platypodia, heart valve disorder);
• High pressure in scrotum and small pelvis veins;
• Another cause of varicocele (varix dilatation) is anatomic characteristics being available in the vain testicular process. The reason why varicoceles occur on the left side mostly is that testicular veins have different movement on left and right side;
• "Symptomatic varicocele" is the case arisen out of postperitoneal side tumour (for example: renal tumours). Therefore we must be very attentive to occurrence of varicocele on the right side, including in underage children or older people.

Statistics:

In 25-30% out of the men addressed with complaints of infertility general population reveals varicocele between 15-20%. 20% out of those serving in military in the USA is diagnosed with varicocele. As majority of people in Azerbaijan marry when a young, 70% out of the men, who had one child without subject to varicocele impact but have failed to have 2nd child for a long time, are diagnosed with varicocele.

Varicocele has 3 forms:

1. Scrotum veins are not palpated and their enlargement is detected via instrumental examination methods (Ultrasound examination, Doppler echocardiography).

2. Scrotum veins are palpated while standing and it is impossible to palpate it while lying.

3. Enlarged scrotum veins are palpated both while standing and lying. Scrotum and spermatic cord veins can be visually determined.

Ultrasound examination has great importance in diagnosing Varicocele (varix dilatation). During Ultrasound examination position and sizes of scrotum can be determined. Valsalva's experiment via Doppler can determine exact flow and flow speed in the scrotum and spermatic cord, including find out whether there is reflux in the veins as well. Another diagnostic process includes measurement of scrotal temperature.

Varicocele can cause high temperature in scrotum which weakens spermatogenesis (formation and maturation of spermatozoa) occurring in the scrotum. Moreover, any person diagnosed with varicocele should give sperm test as without such test it is not good idea to varicocele surgery. Besides, 3 and 6 month following such surgery control sperm test is recommended to find out if the patient’s surgery is successful or not.

It is not difficult to answer the question when varicocle should be treated. Unless there is no diminution in the sizes of scrotum and the patient is a child, then there is no need of urgent surgery (except for the cases when there is up to 20% diminution in the scrotum diagnosed with varicocele in comparison with another one). In such cases it is recommended to wait and the patients to pass ultrasonographic (USG) examination and sperm test once in 6 month. At initial stage of varicocele spontaneity may return.

Treatment of varicocele is necessary when it causes anxiety. Along with it, if varicocele cause slow development of scrotum in children and teenage, then a decision on its treatment may be made. Treatment of varicocele usually leads to increase of scrotum volume in children and teenage. Treatment of varicocele is important in the event of infertility and sperm disorder (quantity, percentage and structure disorder). In such case, improvement is achieved in the quality of sperm.

Note:

Whoever is diagnosed with varicocele should not worry. Nowadays most of the doctors consider that varicocle should be treated when it is the main cause of infertility, size of scrotum faces diminution and or there is sperm disorder. Generally speaking, any young person is recommended to visit urologist- andrologist and to give sperm test and to pass ultrasound examination at least once a year.

Advantages of microsurgical treatment of varicocele:

In recent years microsurgery has been considered as the most efficient, safest and maximum painless treatment method of varicocele and is being applied in the developed countries as a golden standard. Advantages of such surgery include: short surgery period; little surgery area (2cm); up to 0,5-1% of return risk (after treatment with other methods this figure is 17-25%); absence of necessity of hospitalization; and patients’ rehabilitation within short period.

The patient, going to varicocele surgery, understands that such surgery will help to treat male infertility. Scientists have proved that in most cases microsurgical treatment of varicocele will help to restore impregnation ability of sperm. After treatment of varicocele 3-6 month are required for full restoration of all functions.

If you think of microsurgical treatment of varicocele, you are recommended to use contact section of the site.