What is varicocele?

Varicocele is an enlargement, varicose veins in the testicular balls that can occur starting from adolescence. Varicocele occurs in 15% of all men and is the most common cause of infertility in men.

What harm can varicocele do?

Varicocele begins in adolescence, its negative effects gradually increase over the years and over time,

-It can cause infertility.

-It can cause pain that hits the groin and leg.

-It can cause a decrease in testosterone, the male hormone.

-It can cause the testicle to remain small during adolescence.

How is varicocele diagnosed (diagnosed)?

The most important method of diagnosis is the examination to be performed by an experienced urologist.The examination should definitely be performed standing up. Physical examination is the most valuable method.

According to the examination, varicocele is divided into 3 degrees (grade):

1. Grade I (grade I): It is the lightest grade and is only handled by maneuvers such as coughing/straining during an outpatient examination

2. Grade II (grade II): Understood during manual examination without the need to increase intra-abdominal pressure during outpatient examination

3. Grade III (grade III): It is the most severe type and there are varicose veins that can be seen by the eye while standing

In cases that increase intra-abdominal pressure, it is indicated by manually feeling the varicose veins.The second step in diagnosis is scrotal color doppler ultrasonography examination in the presence of conditions that make physical examination difficult.With this examination, the diameters of the diseased vessels reveal whether dirty blood has returned to these vessels, whether there is a loss of volume in the testicle.

How is varicocele treatment?

After the diagnosis of varicocele, first of all, it is necessary to Decipher whether there is a difference between the testicular sizes and the consistency of the testicle. Performing semen analysis, in which sperm parameters are evaluated, is decisive in treatment. If there is no problem with the patient's sperm parameters, it is debatable whether surgery should be performed.

Such patients will be able to disrupt sperm parameters;

-Eating habits

-Smoking and alcohol use

-Exposure to toxic substances

Antioxidant drugs and nutritional methods that correct sperm parameters and the environment in which sperm are located can be recommended. After the diagnosis, the question of which varicocele patients should be operated or not is raised. It is not the right approach to make an operation decision by looking at the grade of varicocele, that is, the grade value. In some cases, 1. Even grade(Grade 1) varicocele can be operated, while in some cases, surgery may not be performed for grade 3 (Grade 3) varicocele. Surgery darkens is a condition that varies depending on the patient.

In the group of patients who have been diagnosed with varicocele but do not have infertility problems or whose sperm parameters are on the limit, supportive treatments may be recommended. Antioxidant agents can be prescribed for patients who have not experienced very severe sperm loss, sperm movement has not completely disappeared, and sperm disfigurement is minimal. However, surgery may be recommended in patients who have been diagnosed with varicocele and whose sperm parameters are impaired and who are experiencing infertility. In such patients, changes in exercise, diet and lifestyle do not have any benefits to eliminate the discomfort.

Op. Dr. Asıf Sadıglı

Urology