Treatment of varicocele

Varicocele is a condition characterized by the varicose enlargement of the veins of the spermatic cord. This condition causes venous blood stasis and insufficient supply of arterial blood enriched with oxygen and essential nutrients. Thermoregulation processes are also disrupted. Over time, all these factors lead to impaired spermatogenesis — that is, a decrease in both the quantity and quality of sperm cells.

Varicocele develops gradually, so at first, a man may not feel any discomfort. Pronounced symptoms typically appear only at stage 2 or 3 of the disease. Early detection is only possible through regular preventive check-ups.

Possible symptoms of varicocele include:

• A feeling of discomfort in the groin area;

• Pain during walking or physical activity;

• Pain during sexual intercourse;

• Enlargement of the scrotum;

• Sagging of the scrotum on one side;

• Shrinking of the testicle;

• Sexual dysfunction.

As the condition progresses, the pain may become constant.

Depending on the severity of clinical symptoms, three stages of varicocele are distinguished:

1. First degree – varicose dilation of the veins of the spermatic cord can be diagnosed during physical examination while standing. Usually, there are no complaints at this stage.
2. Second degree – the vein enlargement is easily detected by palpation, but the size and structure of the testicles remain unchanged. Visual signs may also be absent.
3. Third degree – characterized by a significant enlargement of the veins, which become visible during inspection, as well as an increase in testicle size and structural changes detected by palpation.

Varicocele can develop in boys or men at any age, but it is most often detected during periods of active growth and puberty.

The causes of varicocele include:

• Congenital anatomical features;

• Hereditary predisposition;

• Weakening of the venous walls;

• Hypertension;

• Inguinal-scrotal hernia;

• Narrowing of the renal artery;

• Kidney prolapse;

• Tumors in the groin area;

• Inflammatory diseases of the genitourinary system;

• Scrotal injuries;

• Obesity;

• Sedentary lifestyle;

• Chronic constipation;

• Lifting weights, excessive physical activity, etc.

During the first consultation, a urologist or andrologist will listen to the patient's complaints and ask clarifying questions to get a precise clinical picture. The specialist will also review the patient's medical history, checking for chronic conditions and recent inflammatory or infectious diseases. A physical examination of the scrotum will be performed. In some cases, varicocele can be diagnosed based on external signs.

To confirm the diagnosis, the doctor may prescribe:

• Semen analysis (spermogram);

• Scrotal ultrasound;

• Ultrasound of the pelvic organs and kidneys;

• Doppler ultrasound of the vessels;

• Phlebography;

• Venography and other studies.

In most cases, ultrasound and semen analysis are sufficient, as they reveal changes in the ejaculate typical of varicocele. Other tests may be needed if complications arise or if there are comorbidities.

Varicocele can only be fully cured surgically. However, in the early stages, conservative therapy may sometimes be used. Its main goal is to eliminate the causes that provoke varicose veins of the spermatic cord.

Surgery is performed in cases of stage 2 or 3 varicocele, the presence of complications, or other indications. At «Oxford Medical», minimally invasive techniques are used. These involve the removal or ligation of the damaged vein and restoration of normal blood flow. Patients typically stay at the clinic for no more than 1–2 days, and in some cases, the procedure is performed on an outpatient basis.

At «Oxford Medical», minimally invasive techniques are used to remove varicocele. These involve the removal or ligation of the damaged vein and restoration of normal blood flow. The following surgical methods are used:

• Marmar technique;

• Ivanissevich method;

• Palomo and other techniques.

The choice of surgical method depends on the stage of varicocele and the individual characteristics of the patient. Surgery is performed under local or general anesthesia. Hospitalization is usually required for 1–2 days, but in some cases, the procedure can be performed in a day hospital setting.

With the development of varicocele, blood circulation and thermoregulation processes are disrupted. Therefore, in the later stages, the disease can lead to a decrease in sperm production, reduced motility, and other morphological abnormalities. This poses a risk of infertility. According to statistics, 40% of men with infertility have a history of varicocele. The condition can also lead to other negative consequences.

Possible complications of varicocele include:

• Chronic pain syndrome;

• Disruption of sperm maturation and ejaculation;

• Infertility;

• Prostatitis;

• Phimosis, etc.

Timely treatment helps prevent the development of these complications.

To prevent varicocele, it is recommended to:

• Eat a balanced diet;

• Avoid alcohol and smoking;

• Maintain a healthy body weight;

• Avoid heavy lifting and excessive physical exertion;

• Lead an active lifestyle;

• Visit a urologist annually and undergo ultrasound screening.

At «Oxford Medical», varicocele treatment is performed by highly qualified doctors with many years of experience.

To book an appointment, call the clinic’s contact center or write in the chat on the website.