What are Varicoceles?
A varicocele is when veins become enlarged inside your scrotum (the pouch of skin that holds your testicles). It is like getting a varicose vein in your leg. It might cause male infertility. Pooled blood in the enlarged veins affects the temperature in the scrotum to increase than normal, it affects the ability of the testes to produce sperm resulting in poor sperm health i.e decreased sperm count, decreased motility and poor morphology.
Most of the time, varicoceles cause no problems and are harmless. Less often varicoceles can cause pain, problems fathering a child/infertility, or one testicle to grow slower or shrink.
Most males with a varicocele have no symptoms. Varicoceles may be the cause of fertility problems in about 4 out of 10 men who have problems fathering their first child. They may also be the cause of fertility problems in about 8 out of 10 men who have problems fathering a child after their first.
Many causes of varicoceles have been offered. The valves in the veins may not work well (or may be missing). If blood flow is sluggish, blood may pool in the veins. Also, the larger veins moving from the testicles towards the heart are connected differently on the left and right side. So more pressure is needed on the left side to keep blood flowing through the veins towards the heart. If blood flows backwards or pools in the veins, that can cause them to swell.
Urologists often check for varicoceles with the patient standing. You may be asked to take a deep breath, hold it, and bear down while your urologist feels the scrotum above the testicle. This technique is known as the “Valsalva maneuver.” It lets your urologist find any enlarged veins.
Your urologist may order a scrotal ultrasound test. The ultrasound can also show the size of the testicles.
Often, varicoceles are not treated. Treatment is offered for males who have:
- fertility problems (problems fathering a child)
- the left testicle growing more slowly than the right
- Abnormal semen analysis
There are no drugs to treat or prevent varicoceles. But pain killers (such as acetaminophen or ibuprofen) may help with pain.
When needed, surgery is the main form of treatment. Embolization (briefly blocking the veins) is a non-surgical treatment option.
Varicocelectomy is a treatment option available to treat varicocele. It is a small microsurgical procedure in which all the swollen veins are tied off while preserving the normal blood vessels. There are many urologist in Kenya who do these surgery.
In many patients this can result in a dramatic increase in sperm counts and motility.
Most of the time, patients return to normal activities after 1 week with little pain.
This treatment should be thought about along with other fertility treatment choices.