What You Should Know About Varicoceles

24 July, 2020
Varicoceles are the main cause of masculine infertility, with an occurrence of nearly 40%. However, in most cases, this illnesses doesn't produce symptoms, nor does it lead to difficulties or complications. We'll tell you what you need to know about varicoceles in the following article.
 

A varicocele is an illness that occurs in both men and women, but its rates are much higher among the male population. It involves the swelling of the sperm vessel, which drains the testicles, or the ovarian vein in the case of women. We’ll tell you what you need to know about varicoceles in the paragraphs to follow.

This pathology is the main cause of infertility in men. Approximately 40% of male infertility is the result of a varicocele, according to a publication of the Mexican College of Urology’s Bulletin.

According to expert medical websites like the MSD Manual, this illness is very prevalent. In fact, available data indicates that it occurs in between 15% and 20% of men. However, there are no consolidated statistics regarding its prevalence in women.

In general, the diagnosis of a varicocele takes place between the ages of 15 and 25. It’s very rare for it to appear in men over the age of 45. When it does, it can lead to complications, as it can in cases where the condition goes untreated.

What you should know about varicoceles: the causes

Why do varicoceles occur?

Varicoceles are one of the principal causes of masculine infertility, mainly due to vascular issues.

A varicocele is a dilation of the veins of the spermatic cord, which drain the testicle. In the case of women, it involves the dilation of the ovarian vein. This leads to varicose veins in the pelvic area and causes pelvic congestion syndrome, as an article published in Legal Medicin of Costa Rica indicates.

Varicoceles can be primary or secondary. Primary varicoceles occur because of an anatomic deficiency that impedes the reflux of blood in the seminal duct. At the same time, secondary varicoceles result from other factors, such as a retroperitoneal tumor, carcinoma of the kidney cells, cirrhosis of the liver with portal hypertension, or retroperitoneal fibrosis, among others.

In most cases, varicoceles are extratesticular; only a small percentage of cases involve intratesticular varicoceles. At the same time, it’s more common for the condition to affect the left testicle. However, it can also appear in the right testicle, or in both.

Discover more: Reasons Why the Kidneys Can Hurt

Possible complications

Most cases of varicoceles don’t produce symptoms. However, when they appear, they can be uncomfortable and cause mild pain, especially when standing or making physical effort.

In general, patients only begin treatment when symptoms appear. This can involve a variety of therapeutic or surgical techniques, according to information published by the Mayo Clinic. The same source also states that the main complications of untreated varicoceles are the following:

  • Testicular atrophy: This causes a significant decrease in the size of the testicles. The normal functioning of the gonads is interrupted and, as a result, it can lead to premature infertility or erectile dysfunction.
  • Partial or total infertility: It’s possible for varicocele to produce an increase in temperature in the testicle. This impedes the normal production of sperm and leads to total infertility or difficulty conceiving.

Another complication of untreated varicocele is chronic pain. This pain has the potential to limit or even impede some hip movements. In general, the pain responds well to common pain killers.

Complications with treatment

Surgery to treat varicoceles.

Normally, scrotum support and vasoconstrictor medicines can successfully treat varicoceles. However, if any complication arises, the next step is to perform surgical ligation. At the same time, doctors may conduct a procedure called the embolization of the testicle.

In either case, complications may occur. Below, we’ll describe the two treatments studied by professionals at the University Hospital Center of Coimbra (Portugal):

  • Varicocelectomy or surgical ligation is an ambulatory intervention that, in most cases, doesn’t involve complications. The main risk is damage to the artery that administers blood to the testicle, but this rarely occurs. The procedure may also lead to an infection, bruise, or damage to the surrounding tissue.
  • The embolization of the testicle, at the same time, is a procedure that is minimally invasive and, therefore, safer than a varicocelectomy. The risk of complications is much lower and recovery time is much faster.

Both procedures–embolization and varicocelectomy –have a 90% success rate. The difference lies in that the first doesn’t require a surgical incision, which lowers the risks significantly.

You may also want to read: What’s Delayed Ejaculation?

Other possible risks

As we mentioned previously, these procedures usually don’t involve major complications. However, a study published by Translational Andrology and Urology indicates that we can’t rule out the following possible complications:

  • In a small percentage of cases, treatment–either varicocelectomy or embolization of the testicle–doesn’t improve an individual’s fertility.
  • Sometimes, the procedure fails to reduce the pain that the varicocele produces since the varicose dilations in the scrotum persist.
  • On rare occasions, the formation of hydrocele, or liquid in the scrotum, may occur.
  • In very few cases, patients may suffer from a hemorrhage of variable intensity, which could require another operation.

Seeing a doctor is fundamental

In conclusion, it’s vitally important to emphasize that if you suffer any of the symptoms we mentioned above and believe you may have a varicocele, it’s best to see a specialist. Whether or not you require treatment, a specialist will be able to make a proper diagnosis and dispel any doubts you may have.

 
  • Briceño, L., Díaz, I., Gómez, P., & Cavelier, L. E. (2008). Varicocele e infertilidad masculina. Revista Urología Colombiana, 17(1).
  • Castañeda VJC, Serrano BEA, Tapia SR, et al. Impacto de la varicocelectomía bilateral en el análisis de semen y su efecto en la fertilidad. Bol Col Mex Urol. 2005;20(2):34-40.
  • Anuja Shah. 2017. Masa escrotal indolora. Manual MSD. https://www.msdmanuals.com/es/professional/trastornos-urogenitales/s%C3%ADntomas-de-los-trastornos-urogenitales/masa-escrotal-indolora
  • Sanabria Rojas, Pamela, & Morales González, Fernando. (2015). Síndrome de congestión pélvica como causa de dolor pélvico crónico. Medicina Legal de Costa Rica, 32(2), 129-137. Retrieved May 25, 2020, from http://www.scielo.sa.cr/scielo.php?script=sci_arttext&pid=S1409-00152015000200014&lng=en&tlng=es.
  • Varicocele. Mayo Clinic. https://www.mayoclinic.org/es-es/diseases-conditions/varicocele/diagnosis-treatment/drc-20378772
  • Luís Sepúlveda; Diana Coimbra; Mário Lourenço; Liliana Santos; Catarina Oliveira; Silvia Coutinho; Manuel Ramos. 2018. Varicocele treatment in patients up to 35 years olda multicentric retrospective study comparing 3 different techniques. Centro Hospitalar Universitário de Coimbra. https://dialnet.unirioja.es/servlet/articulo?codigo=6507571
  • Owen, R. C., McCormick, B. J., Figler, B. D., & Coward, R. M. (2017). A review of varicocele repair for pain. Translational andrology and urology6(Suppl 1), S20–S29. https://doi.org/10.21037/tau.2017.03.36