Varicocele

Varicocele Treatment in Chembur, Mumbai

Varicocele is a condition in which the veins of the scrotum (pampiniform plexus) get dilated and distended. 

What do we need to know about varicocele? What are the symptoms?

It is similar to varicose veins in the leg. It is usually visible above the testicles and will almost be invisible when you lie down. It is a very common condition, 10-15 percent of men across the world are affected with this condition.
On touching, varicocele feels like a bag of worms. It may be asymptomatic. There may be scrotal discomfort. The pain may range from being dull to sharp, which increases on exertion and is relieved on lying down.
To seek treatment, you can search for a vascular surgery specialist in Mumbai or visit a vascular surgery hospital near you.

What causes varicocele?

What exactly causes varicocele is not yet known, but studies show that it can be caused by improper flow of blood within the veins of the spermatic cord due to valvular dysfunction. There is pooling and backflow of blood which causes venous engorgement. Varicocele mostly occurs during puberty and is more likely to affect the left side. This is due to the fact that the left testicular vein drains into the left renal vein at an angle.

When do you need to see a doctor?

Most varicoceles do not require treatment and are an incidental finding during routine examination. However, if there is painful swelling in your scrotum or you are having fertility problems, you must immediately contact your doctor. The treating doctor will be a urologist or a vascular surgeon.

You can request an appointment at Apollo Spectra Hospitals, Chembur, Mumbai.

Call1860 500 2244 to book an appointment.

How is varicocele diagnosed?

Varicocele is usually diagnosed by a physical examination. If the varicocele is small, your doctor will ask you to do the Valsalva manoeuvre which helps in detection of the dilated veins. Your doctor might also suggest a scrotal ultrasound scan.

There are grades of varicocele like:

• Grade 0 – Seen on ultrasound but not detected physically
• Grade 1 – Palpable while performing Valsalva manoeuvre
• Grade 2 – Palpable without Valsalva manoeuvre
• Grade 3 – Varicocele causing a scrotal deformity

What are the complications from varicocele?

• Low sperm count and decreased sperm motility which can cause infertility
• Testes may fail to develop or may shrink. This is called testicular atrophy
• Decreased testosterone levels

What is the treatment for varicocele?

Most of the time varicoceles do not need treatment unless they are symptomatic. In cases where you have pain, atrophic testes or infertility, you will want to undergo repair of the varicocele.

The main aim of the surgery is to seal the vein that is affected and redirect the blood flow into the normal venous system.

• Open surgery or Varicocelectomy: It is usually done under local anesthesia. Your surgeon will approach the faulty vein through a groin incision. Incisions may also be made in the abdomen or below the groin. Microsurgical subinguinal varicocelectomy has the highest success rates and the lowest complication rates.
• Laparoscopic varicocele ligation: It is done under general anesthesia. Your surgeon will make an abdominal incision and repair the varicocele through this while visualizing through a laparoscope. There is a risk of development of hydrocele after this surgery, which involves collection of fluid around the testis.
• Percutaneous embolization: In this procedure, a catheter is inserted into your groin or neck vein till it reaches the varicocele. This is followed by using coils to occlude the vein or block the faulty veins using sclerosing agents (produce scar).This is also done under general anesthesia.

Post-operative complications may include:

• Development of hydrocele
• Injury to surrounding structures

It is important to consult a surgeon with good skills if you wish to or are required to undergo varicocele repair to avoid complications.

Conclusion

Varicocele is a common condition affecting men in the pubertal age group and mostly goes unnoticed. Usually, no intervention is required for this condition unless symptoms develop. Varicocele surgery is performed by trained urologists or vascular surgeons in cases of problematic disease.