Varicocele Cause Infertility In Men.
A varicocele is simply an enlargement of the veins within the scrotum.
It only occur in the scrotum and is very similar to varicose veins that occur in the leg. A varicocele can result decreased sperm production and quality, which in some cases can lead to INFERTILITY. It can shrink the testicles as well.
The scrotum is a skin-covered sac that holds your testicles. It also contains the arteries and veins that deliver blood to the reproductive glands. A vein abnormality in the scrotum may result in a varicocele.
Varicocele are common. They can be found in 15% of the adult male population and around 20% of adolescent males. They are more common in males aged 15 to 20..
Varicoceles generally form during puberty and are commonly found on the left side of your scrotum. The anatomy of right and left side of your scrotum isn’t the Same. Varicocele can exist on both sides but it’s extremely rare.
Not all varicoceles affect sperm production..
Causes:
Varicocele are believed to be caused by defective valves in the veins within the scrotum, just above the testicles.
Normally, these veins regulate the flow of blood to and from the testicles. Whenever normal flow doesn’t occur, the blood back up, causing the veins to dillate( enlarge). This most commonly takes place during puberty, when the testicles are experiencing rapid growth and need the most blood.
In about 85% of cases, it occurs in the left testicle area. The poor circulation caused by the varicocele results in a high blood temperature, raising the temperature of the testes, which can serve as a barrier to sperm production and damage or destroy sperm that is created..
Symptoms:
Because a varicocele rarely produces symptoms, it’s common for a man not to be aware that he has one unless it causes problems with INFERTILITY or is noticed during a routine physical exam.
When symptoms do occur, they tend to be felt as a dull ache or feeling of heaviness in the testicles, which gets worse during the day, Particularly in hot weather or after physical exertion.
The dillated veins in the scrotum can often be felt or seen, and the testicles is smaller on the varicocele side..
INFERTILITY is a more common complications of a Varicoclele..
Varicoclele Treatment
Currently there are two treatment options for men with varicoceles: Catheter-directed embolization or surgical ligation
Catheter-directed Embolization
Catheter directed embolization is a non-surgical, outpatient treatment performed by an interventional radiologist using imaging to guide catheters or other instruments inside the body. Through mild IV sedation and local anesthesia, patients are relaxed and pain-free during the approximately two-hour procedure.
For the procedure, an interventional radiologist makes a tiny nick in the skin at the groin using local anesthesia, through which a thin catheter (much like a piece of spaghetti) is passed into the femoral vein, directly to the testicular vein. The physician then injects contrast dye to provide direct visualization of the veins so s/he can map out exactly where the problem is and where to embolize, or block, the vein.
By using coils, balloons, or particles, the interventional radiologist blocks the blood flow in the vein which reduces pressure on the varicocele. By embolizing the vein, blood flow is re-directed to other healthy pathways. Essentially, the incompetent vein is “shut off” internally by preventing blood flow, accomplishing what the urologist does, but without surgery.
Efficacy of Embolization for Varicoceles
Embolization is equally effective in improving male infertility and costs about the same as surgical ligation. Pregnancy rates and recurrence rates are comparable to those following surgical varicocelectomy. In one study, sixty percent conceived who were treated for infertility.
In another study, sperm concentration improved in 83 percent of patients undergoing embolization compared to 63 percent of those surgically ligated. Patients who underwent both procedures expressed a strong preference for embolization.
Recovery Time
- Average of one to two days for complete recovery for embolization, compared to two to three weeks for surgery
- 24 percent of surgical ligation patients required overnight hospital stay, compared to none for embolization
