Varicocele is an abnormality of the venous system in the scrotum often met in men, and is one of the causes of male infertility that can be detected. A great many men with this condition may have no clear symptoms, or only a feeling of heaviness, of dragging pain in the scrotum, or feel swollen veins beneath the skin.
This article explains what a Varicocele is, why it may affect the process of producing sperm, and what a suitable approach to medical assessment should be.
What is a varicocele anatomically?
The scrotum has a venous system whose function is to carry blood that has been through exchange back into the body's circulation. When the valve system in these veins works poorly, blood pools within the veins, so that they expand into swollen veins that can be felt beneath the skin.
This state is called a Varicocele, and is usually found on the left side of the scrotum more often, because of the structure of the venous system in that area.
Why does a Varicocele affect the production of sperm?
The process of producing sperm depends on an environment with a temperature about 1–2 degrees Celsius lower than the core of the body. When blood pools in the veins of the scrotum for a long time, the temperature inside may increase, and the microcirculation, whose function is to deliver oxygen and nutrients to the sperm-producing cells, may work less well.
The result is that the quality and the quantity of sperm may decrease. In some men, a varicocele may be a factor lying behind OAT Syndrome.
The symptoms a man may notice
A great many men with a Varicocele have no clear symptoms, and usually learn of it when they come for assessment of infertility, or when they notice the abnormality themselves.
The symptoms that may be met include a feeling of heaviness or dragging pain in the scrotum, particularly when standing for a long time or exerting themselves; feeling veins with the character of a "bag of worms" beneath the skin of the scrotum; a feeling of discomfort around the scrotum after exercise; and in some men, the affected testicle may become slightly smaller.
When should assessment be sought?
The symptoms or features that should be brought for medical assessment include feeling swollen veins beneath the skin of the scrotum, a chronic feeling of dragging pain in that area, infertility whose cause has not yet been clearly found, and a semen analysis indicating that the quality of the sperm has decreased without another clear cause.
Medical assessment at this stage helps show the character and the level of severity of the state more clearly, before a suitable approach to care is considered.
Assessment with ultrasound
Assessing a varicocele usually uses Scrotal Color Doppler Ultrasonography, an ultrasound examination together with assessment of the flow of blood.
This examination helps the doctor see the character of the expanded veins, assess the level of severity, and examine the effect on the structure of the testicle in detail. The result of the examination is considered together with the semen analysis and other assessments, in order to see the overall picture of this state completely.
The effect on having children
Not every man with a varicocele will have a problem of infertility. In some men this state may be found by chance and does not significantly affect the quality of the sperm.
However, for men in the course of an assessment of infertility, a Varicocele is considered one of the important factors that should be assessed together with the other results. The decision on the approach to care should therefore be based on the effect arising in each individual, not on the finding of this state alone.
The approach to care at PYONG MEN
The approach to caring for a Varicocele that affects the health of the reproductive system at PYONG MEN begins with assessment complete in every dimension, in order to understand the level of severity, the effect on the quality of the sperm, and other contributing factors involved.
The approaches that may be considered include the use of a highly concentrated biological substance (Superdose Activated Purified Growth Factor) to support the process of recovery at cell level, reduce oxidative stress, and reinforce the environment of the reproductive system, together with Transrectal QMR technology and focused shockwave, to help support the circulation of blood and the recovery of the tissue in the area involved.
Where the Varicocele is highly severe, or clearly affects the quality of the sperm, Varicocelectomy surgery may be a suitable option. The doctor will explain the result of the assessment and discuss it together with the person receiving care, in order to consider the most suitable approach for each individual.
In brief
- A Varicocele is a state in which the veins in the scrotum expand because of the pooling of blood
- This state may make the temperature inside the scrotum increase, and affect the quality of the production of sperm
- The symptoms that may be met include a feeling of heaviness or dragging pain in the scrotum, and feeling swollen veins beneath the skin
- The standard of assessment is Scrotal Color Doppler Ultrasonography
- The decision on the approach to care depends on assessment for the individual, and may include non-surgical and surgical approaches
Frequently asked questions (FAQ)
1. Does a Varicocele always have to be treated? Not always. In some men this state is found by chance and does not significantly affect health. The consideration of care depends on the symptoms, the severity, and the effect on fertility.
2. Does a Varicocele make it hard to have children? Not always, but it is one factor that must be assessed seriously in men who are being assessed for infertility.
3. Is surgery for a Varicocele the only option? No. In some cases Varicocelectomy surgery is the clinical standard and a suitable option, but in some cases there may be non-surgical approaches to care, depending on assessment for the individual.
4. Is the ultrasound examination painful? It is not painful. The Scrotal Doppler Ultrasound is an external scan, using gel and a probe, with nothing inserted.
5. If a Varicocele is found but the semen analysis is normal, does anything have to be done? Not necessarily. The doctor will assess the overall picture and consider a suitable approach, which in some men may be following up the result without any immediate clinical action.