Advanced, minimally invasive treatments at affordable costs only at Medfin.

Advanced, minimally invasive treatments at affordable costs only at Medfin.

A varicocele pronounced as VAR-ih-Koe-seel is the enlargement of veins in the scrotum (a loose bag that holds the testicles) in males. A varicocele is similar to varicose veins that arise in the legs.

Varicoceles are a common root for low sperm production and decreased sperm quality, which can lead to infertility. About 15 percent of adult males and 20 percent of adolescent males are diagnosed with this condition.

 It is most commonly diagnosed in the age group of males aged 15-25. Not all varicoceles lead to low production of sperms by the testicles. Varicoceles can also be the reason for the underdeveloped testicles or be responsible for their shrinkage.

Most varicoceles develop during puberty and develop over a period of time. Most varicoceles are easily diagnosed and many don't need treatment. Only when a varicocele causes symptoms, it needs surgical repair.

The doctor will perform a physical examination of the varicocele by evaluating the scrotum. The doctor may ask the patient to stand to ascertain the varicocele, should it not be easily diagnosed.

Further ultrasound or CT scan may be recommended to measure the size and shape of the testicles. If there is any apparent anomaly, the patient will then further be evaluated for varicocele.

1.Overview: It is an image-guided procedure, where a tube (catheter) is used to divert blood flow from a varicocele. This procedure is always performed by an Infrared Radiologist.

2.Snapshots:

  • Procedure Type: Minimally invasive
  • Anesthesia: Local anesthesia/no anesthesia
  • Hospitalization: 1 day
  • Procedure time: Around 1 hour
  • Recovery Time: 1-2 days

3.Post-Surgical Care: 

  • Increase the amount you walk bit by bit, as walking boosts blood flow and prevents constipation
  • Avoid strenuous activities such as cycling, jogging, weightlifting and aerobic exercising for around 3 weeks
  • Avoid sexual intercourse for 1-2 weeks after the procedure.

4.Advantages of this Procedure: Shorter recovery time, leaves no permanent scarring, minimal pain, can be performed as an outpatient procedure. Improvement of sperm quality, shorter post-surgical clinical treatment and low rate of post-surgical complications.

Treatment may not be necessary at all. However, if varicoceles cause pain, swelling, testicular atrophy, or infertility then treatment is required. There are no medications that can treat varicocele. Given below are some of the treatments available: 

Open Surgery: Your surgeon will access the varicoceles through an incision in your groin. The surgeon may sometimes access them through an incision in your abdomen or below your groin. 
The surgeon will then repair the varicocele. This procedure may be done under general or local anesthesia.

Laparoscopic varicocelectomy: Your surgeon makes a small incision in your abdomen and passes a tiny instrument through the incision to see and to repair the varicocele. This procedure requires general anesthesia.

Percutaneous Embolization for Varicocele: Varicocele embolization is a treatment that uses image guidance such as ultrasound or x-ray and a catheter to place tiny coils and/or liquid agents in a blood vessel to seal it and divert blood flow away from a varicocele. 
This is a minimally invasive surgery and can help relieve pain and swelling. It may also improve sperm quality.

The exact cause/s of varicoceles has not been identified. Varicoceles are formed in the veins housed in the spermatic cord that carries blood vessels and nerves to and from the testicles. 

Although, the apparent reason for the formation of varicoceles seems to be because of the disruption of blood flow in the veins carrying blood from the testis to the heart. 

The one-way valves in the veins, which carry this blood, malfunction and this leads to the pooling of blood in them, causing the veins to enlarge. This accumulation of blood over a period of time leads to the formation of a varicocele.

Varicoceles usually form on the left side. This could be because of the position of the left testicular vein.

1.Overview: The surgeon will access the varicocele area through the groin, or through the abdomen or upper thigh. Using ultrasound and surgical microscopes, he’ll close the affected veins to reroute the blood via other healthier vessels.

2.Snapshots:

  • Procedure Type: OPEN Surgery
  • Anesthesia: Local/general anesthesia
  • Hospitalization: 1 day
  • Procedure time: 1-2 hours
  • Recovery Time: 1-2 weeks (4 weeks for full recovery)

3.Post-Surgical Care: 

  • Take the prescribed medicines and follow your doctor’s instructions
  • Apply ice pack to the scrotum for 10 minutes several times a day
  • Do not have sexual intercourse for up to 2 weeks
  • Avoid strenuous activities, do not swim, drive or bathe
  • Do not strain during bowel movement (you may try stool softener). 

4.Advantages of this Procedure: Alleviation of pain and discomfort, better sperm count, normalization of testosterone levels, better sperm quality, better DNA quality in sperm and better chances at achieving pregnancy.

Varicoceles generally do not produce any symptoms. In cases where the pain is reported, the pain:

  • Varies from sharp to dull recurring pain in the scrotum.
  • Can intensify during the course of the day.
  • May increase with physical exertion over an extended period of time
  • Relieves when lying on the back.
  • May even impair fertility.

Some of the physical symptoms include:

  • A lump in either side of the testicles.
  • Swelling in the scrotal sac.
  • Large twisted visible veins of the scrotum also described as a "bag of worms" appearance.

Varicoceles when left untreated can lead to complications such as shrinking of the testicles, also called atrophy, and also infertility.

 Varicoceles might keep the local temperature in or around the testicle too high, affecting sperm formation, movement (motility), and function.

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