Varicocele in men is a common urological condition, but not all patients require surgery.
What does varicocele mean?
Varicocele is the elongation, dilatation and tortuosity of the trapezius plexus of the spermatic cord due to obstruction of the reflux or failure of the venous valves. It is a common urological condition that occurs mostly in young and middle-aged men, accounting for 5%-20% of the male population and 35%-40% of the male infertility population. Due to the anatomical location, it is easy to occur on the left side, but recently it has been found that it occurs bilaterally at the same time.
In layman’s terms, varicocele is caused by the inability of the returning blood to return effectively and its accumulation in the capillary plexus.
What are the risks of varicocele?
Poor reflux leads to stagnation of blood, which in turn leads to high scrotal temperature, poor sperm quality, and ultimately infertility. Since the venous system is connected on both sides, the sperm function of the testes on the opposite side is also affected.
This is the mechanism by which the damage occurs is currently thought to occur. However, it is not true that all patients need surgery. Varicocele is not equal to male infertility, but it is one of the important causes of male infertility.
1.Mild varicocele: clinical symptoms are not obvious, especially in unmarried young people or married people with normal fertility can be left untreated.
2, minor symptoms: scrotal brace can be used to promote blood reflux and reduce symptoms. Avoid excessive sexual life to reduce the venous congestion in the perineum.
How to evaluate the severity?
Clinically, there are three categories according to the severity.
1. Mild: normal appearance, not palpable, can only be felt by holding the breath.
2.Moderate: normal appearance, palpable.
3.Severe: at a glance, it looks like a mass of earthworms and is clearly visible and palpable.
According to the severity, surgery is recommended for moderate and severe varicocele.
Indications for surgery.
1.Heavy symptoms, obvious varicose veins or pain not relieved by non-surgical treatment, or abnormal semen test although varicose veins are very mild.
2, Infertile patients with abnormal semen quality, excluding female factors.
3.Adolescent patients, especially those with reduced testicular volume. The older the age, the longer the disease, the more serious the testicular function damage.
4.Patients with mild varicocele, those with abnormal semen quality found on follow-up.
How many types of surgery are there?
1.Traditional surgery: open surgery, small incision, simple surgery, little damage, is the main program of surgery at present.
2.Laparoscopic surgery.
3.Microsurgery.
What is the effect of surgery?
For the above three, the surgical results are comparable. The post-operative results are related to the severity of preoperative varicocele. The effect on relieving scrotal distension is more obvious, and the improvement on sperm quality is related to the degree of varicocele before surgery. Of course, if there is no sperm in the semen itself, the procedure may not be significant for fertility.
Many patients with varicocele have a combination of prostatitis and spermatic vein surgery is not associated with any improvement in prostatitis symptoms and will not improve any prostatitis symptoms after surgery.