Varicose Veins, Where?

What Is Varicocele?

When someone mentions varicose veins, usually the first place we think of in connection to these knobby, swollen veins is the legs. However, the legs are not the only place on the body to experience the effects of varicose veins. Hemorrhoids are, in fact, varicose veins. So are varicoceles. Varicoceles are swollen veins in the scrotum. In technical terms, it is a dilation of the pampiniform venous plexus and the internal spermatic vein. Tech talk aside, varicocele is a notable cause of decreased testicular function and happens in 15-20 percent of all males. 40 percent of infertile males suffer with varicoceles. What is not known is how a varicocele impairs sperm structure, function, and production. However, researchers believe varicocele causes interference in the heating regulation of the testicles.

How Does Varicocele Affect Fertility?

Varicoceles have a profound effect on the production of sperm as well as the quality of the semen. While many theories have been proposed, none of them have been proven yet. However, whatever the relationship, a varicocele is a significant factor in men seeking fertility help. Usually, a man has no idea he has a varicocele until he has difficulty with fertility. It is only with careful physical examination that a varicocele is detected. Varicoceles, undetected, can cause significant damage to the testicles and are possible contributors to unexplained male infertility.

Can It Be Treated?

There are no effective medical treatments available for varicoceles. Some investigation is taking place on the role of antioxidants to the problem, but the approach is still experimental. The primary form of treatment for varicoceles is surgery. However, there is a high risk of significant testicular damage during a surgical procedure, so evaluation is critical. Not all varicoceles require surgery. When surgery is necessary, it is important that the blood flow to the testis is preserved, and that discomfort and pain is minimized.

There are three different areas in which repairs can be made, including the groin area, abdominally, and from below the groin. In all three approaches, all of the abnormal veins are tied off, preventing blood flow. The most commonly used areas on which surgery is performed are the groin and below groin approaches. There are many considerations in any surgery and the primary concern in varicocele surgery is to ensure the testis remains functional and intact with the testicular artery preserved and the veins causing the problems, properly addressed.

Great Success With Surgical Repair

Varicocele repair has an excellent success rate with records of increased conception rates in infertile couples. Injury to the testicular artery has been reported to be 0.9 percent in microsurgical varicocele repairs. About 70 percent of patients have improved bulk semen ratings and between 40-60 percent have increased conception rates. However, since it takes about 72 days for sperm to revive and regenerate, the improvements are not usually seen for three to four months after the surgery.

Varicocele repair is considered by some medical professionals to be better than ICSI when it comes to cost effectiveness. ICSI (intracytoplasmic sperm injection) is a method of conception where a single spermatozoon (sperm) is injected into an oocyte (egg) to fertilize it. Varicocele repair is less expensive and it has the potential for improving the male factor, rather than using unknown sperm. ICSI also requires IVF, which carries its own risks for women. Varicocele repair eliminates this risk.

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