Varicocele treatment
Varicocele treatment in Turkey Varicocele occurs in the varicocele plexus (tendon plexus) of the scrotum (the sac of skin and smooth muscle that holds the testicles) and affects up to 10%-15% of males and occurs in children and grows and develops over time and can occur Varicocele on both sides. However, this is rare and we believe it is more common on the left side of the scrotum due to the difference in testicular anatomy. They are often harmless and do not cause problems, but a varicocele can cause pain, reproductive problems, or delay the growth or shrinkage of the testicles.
How is varicocele formed?
Sperm and testosterone are formed in the testicles and the sperm matures as it travels through a coiled tube called the epididymis. It is located behind each testicle and then the sperm travels to the prostate through a tube called the months.
Semen mixes with sperm in the prostate to form semen upon ejaculation. The semen travels through the urethra and exits from the end of the penis to the outside. The spermatic cord consists of the vas deferens (the duct that carries the semen) and the artery of the testicle (the testicular artery), which transports blood to the testicle and also Plexus (plexus tendrils) is a group of veins that drain blood from the testicles. And the testicles need a certain temperature so that it is less than the basic body temperature in order to produce sperm, mature it, and perform its function perfectly, and this temperature is about five degrees less than the temperature of the abdomen or pelvis.
The varicose plexus acts as a heat exchanger, cooling the blood in the testicular artery before it enters the testicles. This helps keep the temperature within the right range to produce good sperm. But when these veins become enlarged, as in the case of a varicocele, it can overheat the testicles, resulting in decreased sperm production and decreased fertility.
What are the symptoms of varicocele?
Most males with varicoceles have no symptoms. But it is a concern for many reasons.
- Some may cause infertility (problems conceiving) and slow growth of the left testicle during puberty.
- It is possible that varicocele is the cause of fertility problems in 0.4% of men who suffer from difficulties and problems to have their first child. It may be a cause of fertility problems in about 0.8% of men who have problems conceiving a child after their first child.
What are the causes of varicocele?
Many causes of varicocele have been presented.
The valves (valves) in the veins may not work properly (or they may be missing). And blood may collect in the veins in the event that the blood flow is slow, and the large veins are connected. (which go from the testicles to the heart). Differently between the right and left sides. For this reason, the left side may need more pressure to maintain proper blood flow through the veins heading to the heart. And if the blood flows backward or collects in the veins, this may cause them to swell.
Is it common for this to happen?
About 15 out of every 100 men suffer from a varicocele. It is difficult to predict which of these 15 will suffer from fertility problems caused by varicocele. But about 4 out of 10 men tested for fertility problems have a varicocele and decreased sperm motility. There is no association with other defects, race, place of birth or ethnic group. Although a varicocele is often found in men who are tested for infertility, 8 out of 10 men with a varicocele do not have fertility problems.
How is a varicocele diagnosed?
A varicocele is diagnosed through a self-examination of the scrotum or during a routine doctor’s examination where urologists check for a varicocele. First, by standing the patient, then taking a deep breath, holding it, and then squatting. During this, the doctor feels the scrotum. This technique is known as the “Valsalfat maneuver,” which allows the urologist to find any enlarged veins. The urologist may order an ultrasound of the scrotum if a problem is felt during the maneuver. Where ultrasound is used to form an image of what is inside the body, and through it, veins that are more than 3 millimeters wide are found (which is a sign of varicocele). The ultrasound also shows the size of the testicles.
What is the treatment of varicocele in Turkey?
The treatment of varicocele is not involved in many cases, but the matter is treated due to the following matters:
- Having fertility problems (problems having a baby).
- feeling pain.
- Slow growth of the left testicle more than the right testicle.
- Abnormal semen.
There are no medications to treat or prevent varicocele. However, pain relievers (such as acetaminophen or ibuprofen) may help relieve the pain. Surgery is the main method of treatment, while the non-surgical method is embolization embolization (blockage of the veins for a short time)
Surgery:
There are many ways to perform varicocele surgery but all involve blocking blood flow in the veins of the varicocele plexus.
The surgery is performed under general anesthesia, and there are two ways to do it:
- Varicocele resection with a microscope: The surgeon makes a 1 cm incision above the scrotum and from the varicose veins. The surgeon then ligates all the small veins using a microscope and preserves the vas deferens, testicular arteries and lymphatic drainage. The operation takes 2 to 3 hours and the patient goes home the same day.
- Laparoscopic varicocele resection: The surgeon inserts thin tubes into the abdomen, and the vein is tied. The procedure takes less time than the previous one, due to the presence of fewer veins in the abdomen. (about 30-40 minutes) and the patient goes home the same day.
Surgery results:
Recently, surgeons use smaller incisions in the muscles in their open operations, and for this reason, pain rates are close at the time of recovery, whether with microsurgery or endoscopic surgery.
Problems after surgery are rare, including:
- Not all varicoceles disappear or recur.
- A lump (hydrocele) forms around the testis.
- Testicular artery injury.
Surgery in many cases treats the matter and rarely fails, but in rare cases, injury to the testicular artery can lead to loss of the testicle and the problem also rarely persists or reappears >0.1%
Embolization (embolization) through the skin:
It is performed by a radiologist under light local anesthesia injected into the thigh or neck. During which a contrast injection is used and this is accompanied by X-ray guidance. The goal here is to find all the veins that lead to the varicocele. During this, coils and tampons are used, with or without a sclerosing agent, to prevent blood flow to the varicocele. The operation takes 45 minutes to an hour.
Some of the problems are:
- Not all varicoceles disappear or recur.
- A lump (hydrocele) forms around the testis.
- infection.
Post-treatment:
The time required to complete the recovery phase after surgery is relatively short and painless, and during this phase you should avoid exercising for 10 to 14 days. You can return to work after 5 to 7 days. In the event that the reason for the operation is fertility problems, then a semen analysis is performed after three to four months.
The effect of varicocele repair on fertility is not clear, as some studies show an improvement in fertility after treatment, while other studies do not, but an improvement in semen quality is 0.6%. of men experiencing infertility after treatment. We also note that the main reason for performing surgery in adolescents is slow testicular growth.
Varicocele treatment in Turkey:
There are many reasons that are not related to sexual competence and that hinder fertility, such as the production of abnormal sperm. Or the presence of a defect in its function for genetic or pathological reasons, and exposure to specific environmental factors may lead to a defect in sperm production. such as pesticides and radioactive materials, in addition to some other health problems that affect fertility in general, and it is not easy to talk about these problems for most men, but is it wise to live with them!!
The medical staff of the surgical teams, doctors and consultants at the Health and Beauty Hospital can provide the best treatment options and free consultations – through their relentless pursuit of keeping abreast of the latest technologies and medical methods.