The Most Common Cause of Male Infertility: Varicocele

The most common cause of male infertility is varicocele
The most common cause of male infertility is varicocele

Urology Specialist Op.Dr.Murat Mermerkaya gave important information about the subject. Varicocele means swelling in the veins of the testicle. This situation can disrupt the sperm and prevent having children. When varicocele is operated, this problem is solved and pregnancy occurs. The most successful method in surgery is microsurgery. What is a varicocele? Does varicocele go away over time? Does varicocele reduce sperm count? Does varicocele affect sexual life? all and more in the details of the news ...

Does varicocele go away over time?

Varicocele does not resolve on its own unless it is surgically treated. Varicocele is the condition of enlargement of the veins around the testicle, while the enlargement of the vessels gradually increases and the varicocele may become the most severe, it is not possible to recover spontaneously without treatment.

Does varicocele reduce sperm count?

Untreated varicocele causes more damage to the testicles as time passes. It decreases the number and movements of the sperm and also distorts their shape. As a result, it may prevent having children. Surgical ligation of dilated vessels corrects decreased testicular function. Sperm count and quality improve in 80 percent of men who have had an operation.

Does varicocele affect sexual life?

Varicocele has no effect on sexual activities. However, severe varicocele may affect the testicle over many years and may contribute partially to the decrease in testosterone-male hormone that may occur in later ages. In this case, the structure of the testicles is broken and they cannot produce male hormone (testosterone) as before. As a result, sexual problems may occur in men.

What are the symptoms of varicocele?

Varicocele symptoms are very important for the diagnosis and treatment of the disease. Varicocele on the testis;

  • Swelling
  • Puffiness
  • It may give symptoms in the form of pain in the testicles.

After a while, the enlargement in the veins becomes apparent enough to be seen from the outside and can take a varicose-like shape seen in the legs. Symptoms of varicocele include swelling and a feeling of warmth, as well as swelling in the testicles. Shrinkage of the testicles, which is one of the symptoms of varicocele, can be seen in some patients, although it is rare.

What causes varicocele?

The cause of varicocele is unclear. It is seen in 15-20% of individuals who have children in the society even in adult ages. It is observed at a rate of 30-40% in men who apply for infertility. Secondary infertility, that is, in those who have had a child before and apply for a child again, this rate can rise up to 60%.

Varicocele is seen in the left testicle in 90%, while it is seen bilaterally in 8-9%. The rate of occurrence only on the right side is 1-2%. The fact that varicocele is mostly seen on the left side depends on some anatomical factors.

  • The testicle on the left side is slightly lower than the one on the right
  • The vein on the left side of the testicle is longer than the right side.
  • The anatomical relationship of the left testicular vein with other adjacent organs in the abdomen.
  • Among the features such as the anatomical structure of the discharge form of the left testicular vein, varicocele is among the reasons for the more left side.

How to understand varicocele?

Careful people can identify varicocele from irregularity, swelling or pain on the testicle while self-examination. Varicocele is mostly diagnosed during the doctor's examination in applications made with the complaint of infertility. Also; Pain experienced after situations that require effort such as prolonged standing, sports or sexual activity may indicate varicocele. Varicocele examination is performed as a part of genital examination. The patient should be examined in a standing position at a room temperature of 21-22 degrees. Testicles and genital area are observed while the patient is standing upright. The patient is checked by eye and hand both in the normal position and by doing straining maneuvers. With normal and straining maneuvers, it should be determined whether there is an enlargement in the vascular structure. The presence of varicocele is clinically established with these procedures. The gold standard in diagnosis is a doctor's examination. In addition, Scrotal Doppler ultrasonography is performed to support the clinical diagnosis, determine the degree of varicocele and to decide on the operation.

How is varicocele treatment?

After the diagnosis of varicocele, it should be checked whether there is a difference between testicle sizes and the consistency of the testicle. Performing semen analysis, in which sperm parameters are evaluated, is decisive in the treatment. If there is no problem in the sperm parameters of the patient, it is controversial whether to be operated on or not.

It may impair sperm parameters to such patients;

  • Eating habits
  • Smoking and alcohol use
  • Exposure to toxic substances

Antioxidant drugs and nutritional methods can be recommended to improve the sperm parameters and the environment where the sperm is located. After the diagnosis, the question arises which varicocele patients will be operated or not. It is not the right approach to decide on surgery by looking at the varicocele grade, that is, the grade value. In some cases, even a Grade 1 varicocele can be operated on, while in some cases, surgery may not be decided for a Grade 1 varicocele. Surgery darkens, it is a situation that varies according to the patient.

Supportive treatments can be recommended for patients who are diagnosed with varicocele but do not have infertility problems or who have borderline deterioration in sperm parameters. Antioxidant agents can be given to patients who have not experienced severe sperm loss, sperm motility is not completely lost, and sperm deformity is minimal. However, surgery may be recommended for patients who have been diagnosed with varicocele and who have impaired sperm parameters and experience infertility. Exercise, diet and lifestyle changes do not provide any benefit in relieving discomfort in such patients.

Armin

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