Varicocele

What is the Varicocele?

Varicocele is varicose-style enlargement of the veins that drain the blood in the testicles in the legs. This condition is frequently (90%) seen on the left side, while 8-9% is bilateral, 1-2% is seen on the right side. The reason why it is observed more frequently on the left side is related to the anatomical structure of the left vein and its course in the body

What is the prevalence?

The prevalence rate among men in the society is between 15-20%. Infertility is encountered in about 30-40% of those who apply to a doctor.

Symptoms

• Infertility: Testicular functions are affected by deterioration of testicular temperature and accumulation of toxic substances in the testicle. This situation primarily disrupts sperm production and, in advanced stages, testosterone production. Varicocele is the most common cause of correctable male infertility.
• Swelling in the testicles: The enlargement of the veins can become apparent from the outside after a while and may look like varicose veins in the legs. This situation manifests itself in the form of swelling and swelling from the outside.
• Testicular pain: Varicocele pain is an irritating blunt pain in the test. This pain can usually be felt in the groin area and testicle, as well as occasionally radiating to the leg.
• Shrinkage in the testicle: Varicocele may cause a shrinkage in the size of the testicle, which is responsible for sperm and male hormone production. This situation can manifest itself with infertility, sexual reluctance and sexual dysfunction.

What is the reason?

It is not entirely clear what causes varicocele. However, it is known that it is observed more frequently in those who are engaged in heavy sports that increase intra-abdominal pressure, those who have chronic constipation problems, those who have chronic cough problems, those who do professions that require continuous standing, and tall and obese men.

How is it diagnosed?

Varicocele is diagnosed by palpation. According to the examination findings, varicocele is divided into 3 degrees. After the diagnosis of varicocele, testicle size and consistency should be checked. Scrotal Doppler Ultrasonography can be performed when necessary to support clinical diagnosis, but it is not absolutely necessary for diagnosis. Performing semen analysis, in which sperm parameters are evaluated, determines the necessity of treatment.

Varicocele treatment

If there is no infertility problem in people diagnosed with varicocele, supportive treatment may be recommended if testicular sizes and semen parameters are not affected. In order to make a decision for surgery, it is necessary to demonstrate the varicocele problem with examination in the patient and to show that this situation affects the sperm parameters. Again, surgery is recommended if there is a volume difference of more than 10% between testicular sizes due to varicocele in adolescents

Varicocele surgery should be performed with a microsurgical technique using a microscope. Expanded veins are tied under microscopic magnification by entering through a 2 cm incision from the groin area. It is very important to use the microsurgical method in order to prevent damage to the arteries, lymphatics and sperm-carrying ducts and to prevent unwanted complications. Again, the risk of recurrence of varicocele after surgery performed with microsurgical method is very low and close to zero percent, while this rate is around 15% with classical technique.

Varikosel ameliyatı için microcerrahi neden önemlidir?

Bu işlem güçlü operasyon mikroskopu altında gerçekleştiği zaman;

• Ameliyat sonrası nüks (tekrarlama) ihtimali çok düşüktür (<%1).
• Başarı oranı (sperm parametrelerinde düzelme ve gebelik şansı) daha yüksektir.
• Komplikasyon riski (lenfatik, atardamar ve sperm kanallarının yaralanması) oldukça düşüktür.