In modern medicine, phlebological diseases are often diagnosed in males. One of them is varicocele, the stages of development of which will be presented below. This pathology is an expansion of the veins in the testicles and spermatic cord. Usually such a disease is observed in sixteen-year-old adolescents, it often leads to infertility. According to statistics, pathology is diagnosed in 16% of men worldwide, in 90% of cases it leads to a disorder of spermatogenesis.
Characteristics and description of the problem
Varicocele, the stage of development of which will depend on the method of therapy, is a testicular varicose veins that form plexuses in the form of a bunch of grapes.
The disease develops as a result of a violation of the valves in the veins, so there is a violation of the reverse outflow of blood. Pathology is accompanied by pain, discomfort and a feeling of heaviness in the scrotum. In some cases, there is a rupture of blood vessels and hemorrhage into the scrotum, as well as an inflammatory process. In the absence of therapy, the disease progresses and leads toreduction in testicle size, development of infertility.
The initial stage of varicocele does not pose a threat to the patient's life and does not bring him any special problems. In advanced cases, complications and negative consequences develop. Often, the pathology proceeds without symptoms, so men do not go to the doctor, which aggravates the situation. In most cases, the left testicle is affected, as it differs in the anatomical development of the venous system.
The disease provokes the development of infertility, which is characterized by the presence of three factors: a decrease in the number of spermatozoa, their inferiority, impaired mobility and ejection. Varicocele contributes to the dysfunction of the testicles, an increase in their internal temperature, which leads to damage to the seed.
Causes of disease development
The stages of varicocele in the photo can be found in medical institutions on special stands along with information about the pathology. Doctors say that the cause of the disease is an increase in pressure in the veins as a result of their special anatomical location.
Provoking factors include:
- strong force loads for a long period of time;
- diseases of the vascular system leading to high blood pressure;
- thrombosis;
- insufficiency of the connective tissue that lines the venous walls;
- congenital malformation of the inferior vena cava;
- venous hypotension;
- increased intra-abdominal pressure with constipation;
- finding the body inupright long period of time;
- prolonged squeezing of the kidney veins.
Varicocele in men: stages of development
The disease goes through several stages of development. It usually manifests itself in adolescence, reaches a certain degree of development and is no longer aggravated. The transition from one degree to another is rare.
The following degrees of pathology are distinguished:
- Stage 1 varicocele is asymptomatic, pathology is usually detected on ultrasound or Doppler ultrasound. There are no visible changes, sometimes the patient may feel heaviness in the testicle.
- Stage 2 varicocele shows signs when standing or after prolonged exercise. In this case, you can feel the dilated veins.
- Stage 3 varicocele is characterized by dilated veins that can be found in any position of the body. Symptoms of pathology begin to bring discomfort to a person.
- Varicocele stage 4 is characterized by pronounced symptoms. On visual inspection, you can detect varicose veins. At this stage, pathology often leads to the development of infertility.
Symptoms and signs of illness
The initial period of the development of the disease is asymptomatic. At the first stage of varicocele, it is not possible to identify the disease, so men do not go to a medical institution, it can be detected during a preventive examination.
As the disease progresses, pain appears in the testicle, scrotum, groin area. The scrotum may be drooping or enlarged on one side, usually the left. Such manifestations are possible in the second stage of varicocele. In some cases, there may be discomfort when walking, increased sweating, burning in the scrotum. Sometimes a visual examination reveals testicular descent, sagging half of the scrotum.
In the last stages of varicocele, the connection between power loads and pain disappears. The pain is permanent. On examination, the doctor reveals a large number of veins that resemble bunches of grapes. The testis and half of the scrotum are still enlarged. The asymmetry becomes pronounced. In some cases, the pathology becomes chronic.
Diagnostic measures
Examination is conducted by a phlebologist. Usually the diagnosis is not difficult. First, the doctor examines the history of the disease, conducts a survey and examination of the patient to determine the prescription of the pathology and the causes of its development. Particular attention is paid to the presence of injuries in the lumbar region.
Depending on the stage of the varicocele, the doctor may, during a visual examination, detect nodes of a vine-shaped form. The veins on palpation will be tortuous, soft. In some cases, the affected testicle becomes flabby and reduced in size. Palpation is carried out in the vertical and horizontal position of the body, and the Valsalva test is also performed. Then the doctor prescribes the following diagnostic methods:
- laboratory blood and urine tests;
- Ultrasound of the kidneys, scrotum and space behind the peritoneum;
- MRI, CT to detect thrombosis and other vascular pathologies;
- spermogram is assigned to patients who are eighteen years of age;
- dopplerography, thermography and thermography;
- renal-ovarian and antegrade venography;
- transscrotal testicle phlebography.
Also, in the presence of infertility, the doctor prescribes such a study as a MAP test to exclude the immunological factor of the pathology, in which antisperm antibodies are formed in the body of a man that prevent the conception of a child.
As additional diagnostic methods use:
- MIS analysis to study the morphology of male germ cells;
- HBA test to assess sperm maturity;
- Studying the DNA of sex gametes for damage.
There can be many reasons for the development of pathology, so it is important to identify all the existing disorders that affect the formation of pathology. Photos of the stages of varicocele can be found in the office of a urologist or phlebologist.
Among the causes can be inflammation, hormonal and genetic disorders, addictions, poor diet and many others.
Pathology Therapy
If the cause of the pathology is vascular disease, then the underlying disease is treated. Surgical intervention in the first and second stages of varicocele is not resorted to. In this case, methods are used that help eliminate congestive processes in the small pelvis. Patients are advised to avoidexcessive exercise, to treat chronic constipation. Elderly patients are prescribed to wear a suspensorium.
Also prescribed massage of the testicles in a horizontal position of the body, physical exercises, in which you need to go down and up on your toes, do the slopes several times a day. The use of antioxidants, amino acids to normalize sperm motility and improve sperm quality.
Every six months you need to be examined by your doctor. For six months, the patient must take antioxidants. If there is a positive result, the doctor can extend the treatment for one year. If therapy is ineffective, after six months, the doctor recommends using methods of additional reproduction, such as IVF.
Surgery
Surgical intervention is performed at the last stages of pathology development. The indications for surgery are:
- severe pain and discomfort;
- oligospermia;
- impaired development of the affected testicle during puberty;
- cosmetic defect.
In surgery, several methods of surgical intervention are used for this disease:
- Ivanissevich operation, in which ligation or removal of a pathological vein is performed. To do this, an incision about five centimeters in size is made in the area of \u200b\u200bthe entrance or exit of the inguinal canal, through which the vein is removed.
- Endoscopic surgery, during which they performthree punctures in the abdomen, an endoscope is inserted through one, and the affected vein is tied up. The duration of this operation is fifteen minutes.
- Sclerosis of veins. In this case, a vein is punctured, where a catheter is inserted, a sclerosing substance enters through it, which stops the flow of blood. Instead of this substance, a small metal spiral can be installed, which will serve as a "plug". This operation is performed on an outpatient basis, the patient can go home the same day. Such surgery has a number of advantages: it does not involve an incision and suture, it is performed under local anesthesia, a low risk of recurrence, treatment in an outpatient clinic.
- Microsurgery or laparoscopy, in which vein ligation is performed. Reducing the risk of relapse. These techniques contribute to the preservation of the integrity of the spermatic artery and reproductive function.
- Bypass involves the insertion of a shunt into the affected testicle, through which the outflow of blood is carried out.
- Laser surgery is also used frequently. This method of therapy makes it possible to eliminate the pathology under local anesthesia. In this case, there is no blood loss during the operation, the risk of tissue injury is minimal, the recovery period passes quite quickly, there is no scar in the healing process, and the possibility of coagulation necrosis is reduced to zero, the patient does not experience discomfort.
Such surgical interventions are performed without blood loss, which contributes to the rapid recovery of the patient.
Afterone month of surgery is required for rehabilitation. During this period, it is recommended to avoid sexual intercourse, exclude physical activity, the use of s alty, spicy foods. After the surgical intervention, the genitals return to normal, the cluster of veins disappears. After six months, the patients normalize their reproductive activity, so it is possible to conceive a child.
Complications and consequences
Complications can appear at every stage of the disease. In medicine, there are two groups of complications:
- First and second severity of pathology. With the ineffectiveness of surgical intervention due to the negligence of the surgeon, the risk of relapse increases. To prevent this, it is necessary to palpate the testicle before the operation and pass all the necessary tests. Of course, operations in the early stages of the disease are performed infrequently, but the use of such a method of therapy is not excluded.
- The third and fourth stages of the disease can lead to the development of infertility if the therapy was ineffective or was carried out out of time. Often at these stages, testicular atrophy occurs due to a violation of the outflow of blood to it and the spermatic cord.
Forecast
Good results are achieved with the timely elimination of congestion in the pelvic organs. The prognosis will be good if patients follow the doctor's recommendations: limit power loads, normalize the activity of the digestive tract, lead a he althy lifestyle and have regular sex life with a regular partner, eliminate harmfulhabits, normalize rest and work.
Prevention
Preventive measures should be observed at any age. In children, the pathology can be congenital or acquired, the first degree of the disease is mainly diagnosed. In childhood, the disease is treated with medication. At the age of twenty, it is recommended that every member of the stronger sex be examined by a urologist. If varicocele is not detected at this age, then the disease will not develop in the future. It is important to remember about the right lifestyle, moderate power loads, the use of vitamins and minerals. All this is the prevention of the development of varicose veins of the testicles and spermatic cord.
Thus, varicocele is a common pathology among males, which often leads to the development of infertility. With timely and effective treatment, this problem can be fully solved, a person will be able to conceive a child. In severe cases, the disease leads to negative consequences. It is important to follow all the prescriptions and recommendations of the doctor, then the pathology can be eliminated, and the risk of relapse is minimized.
