Varicocele sounds quite unusual, but this pathology is quite common among men and is a varicose deformity of the veins located in the spermatic cord and testicles. Such an ailment has a lot of not entirely pleasant symptoms, which can be followed by a violation of the process of spermatogenesis and problems with reproductive he alth, flowing into early infertility. In this article, we will find out why varicocele is dangerous, how this pathology manifests itself and what is the opinion of specialists regarding treatment.
Characteristics of the disease
Among the great variety of diseases of the urological nature, varicocele occurs in one in ten men who went to the doctor with complaints of swelling, soreness and swelling in the groin.
The name of the disease is Latin, which literally means "swollen veins, swelling".
A few factsabout varicocele:
- It is a pathology due to which the veins of the testicle and spermatic cord change.
- The most common lesions are the internal spermatic vein and the left testicular vein.
- 67% of all manifestations of venous varicose veins occur on the left side of the body.
- Vasodilation, unfortunately, is an irreversible and persistent phenomenon.
- As a result of the thinning of the walls of blood vessels, deformation of the veins occurs, knots appear.
- Blood flows through deformed vessels less and more slowly.
- As a result, blood stasis forms in the vessels of the testicle and spermatic cord.
- There is inflammation of the surrounding tissues and their subsequent swelling.
- As swelling increases, pain, heaviness and discomfort appear, which disturb the man with every movement.
- What is the danger of varicocele? If the disease progresses, then the process of spermatogenesis is possible, which, in turn, is the cause of early male infertility.
Reason for development
At the moment, doctors distinguish three main reasons why men develop varicocele:
- Increased pressure in the renal veins.
- Defect of the testicular vein. May be valvular or anatomical.
- Combination of both pathologies.
Sometimes pathology can occur as a result of constant physical exertion and overwork, which cause an increase in intra-abdominal pressure or compression of the kidneyvessels.
What is the danger of varicocele? This question interests many. Let's figure it out.
The process of occurrence of pathology
- Anatomically, the inguinal ring is connected to the testis by the spermatic cord.
- It is important that inside the inguinal ring is located not only the vas deferens, but also the vessels: venous, lymphatic, arterial.
- There are specific valves in the vein, through which the outflow of blood is regulated.
- Varicosis affects the pampiniform plexus located in the cord.
- The spermatic vein expands, its walls become thinner, knots appear.
- There is a violation of the outflow of blood from the vessels of the testicles.
- If there is an anatomical defect on the left side, then the outflow of blood is difficult on the left.
- As a result of impaired lymph flow and blood flow, inflammation or complete rupture of the veins may occur, followed by hemorrhage into the scrotum.
- Progressive varicocele can cause infertility in men.
Causes of impaired blood flow
- It is considered normal when, in a standing position, the blood flow through the veins is directed from the renal veins down to the pampiniform plexus.
- In the supine position, the blood flow through the veins should be directed from the veins of the testicles to the veins of the kidneys.
- In the case of expansion and deformation of the venous vessels, the progression of varicocele begins.
- If there is chronic high blood pressure in the vessels of the kidneys, then the discharge of blood occurs through collaterals. One such vessel is the testicular vein.
- Renal hypertension may be caused by vascular thrombosis and an anatomical defect.
- Hemodynamic disturbance may occur in case of severe shunting of blood from the abnormal testicular vein into the renal vein.
- Permanent changes in the flow of blood through the veins can result from a birth defect or a defect resulting from an injury.
As a result, there is a constant stagnation of blood in the vessels of the scrotum. The result is an increase in venous pressure in the testicular vessels up to 3-4 times. In this case, with varicocele, testicular surgery is simply necessary.
Stages of varicocele
Many factors affect the symptoms of pathology. Modern medical professionals prefer to use a four-stage classification, according to which doctors can draw up an effective treatment plan and predict recovery. So, four stages of varicocele:
- The first stage. At this stage, varicose veins of the testicular vein and veins of the spermatic cord are observed. Moreover, its determination is possible only with the help of dopplerography.
- Second stage. The deformation of the varicose nature can be determined by palpation in a standing position. Is surgery dangerous for varicocele? More on that later.
- Third stage. Identification of varicose changes is possible not only in the standing position, but also in the prone position.
- The fourth stage. Nodularity and deformity of the veins can be determined by examining the genitals.
Such a pathology can be detected inabsolutely any age. In adolescents and young men, varicocele occurs most often during puberty. In older men and the elderly, the disease may be the result of existing renal hypertension in the primary stages or a congenital vascular defect, previous injuries. That is why it is important to take into account the history and existing diseases in the diagnosis of varicocele (photo can be seen in the article).
Classification of varicocele
Today, more than one classification is used. Each of them takes into account the exact reasons for which the disease arose, as well as the individual characteristics of each of the forms in which the disease proceeds. Specialists in the field of urology and nephrology in their practice distinguish more than five scales.
Classification by the affected side. One of the forms is a left-sided varicocele. In this case, the left testicular vein is affected. Right-sided varicocele occurs in about 50% of cases, while the right testicular vein is affected. The rarest form is bilateral varicocele. Occurs in only 5-6% of patients.
Classification by type of blood discharge. The first type is varicocele, in which there is a discharge of blood from the renal veins into the testicular veins. The second type is a pathology in which the discharge of blood occurs from the iliac vein. The third type is varicocele with combined shunting of blood from the renal veins and from the iliac veins.
Classification according to the etymology of occurrence. UrologistsDistinguish between primary and secondary varicocele in men. In the first case, the disease has a congenital origin, may be the result of genetic and anatomical abnormalities in the renal vessels, in their valves, in the vein of the spermatic cord. In the second case, it is the result of thrombosis, trauma, neoplasms in the pelvis and in the abdominal cavity, squeezing the vessels of the spermatic cord from the outside.
Symptoms may be mild or severe. It all depends on what stage the disease is at.
Symptoms of the first stage
- Rare pain in the groin area after sports or physical overwork.
- In addition, the disease can be diagnosed by a urologist or surgeon during a mandatory medical examination.
What is the second stage testicular varicocele dangerous for?
Symptoms of the second stage
- Periodic discomfort in the groin that occurs after making sudden movements.
- Discomfort after lifting heavy objects, running or walking for long periods of time.
- Unpleasant sensations are manifested as pulling and unpleasant pains of a aching nature, like tingling. Patients note that the pain is not pronounced, but is prolonged.
- Some patients report slight testicular sagging, sexual dysfunction.
- With the progression of varicocele in men (which is dangerous, we will consider below), a pronounced asymmetry of the scrotum may appear.
Third stage symptoms:
- Pronounced dependence of the appearance of pain along the spermatic cord from physical exertion.
- Manifestation of pain mainly on one side.
- The appearance of throbbing and arching pain in the scrotum after changing body position.
- Pain at rest, at night.
- Sexual dysfunction - examination allows visual identification of a noticeable asymmetry of the scrotum.
- Appearance of nodular dilated veins under the skin, pain when touched.
Is varicocele dangerous?
Pathology as such is not dangerous, but the complications that may arise pose a significant threat to the he alth and life of a man, and at any age. An untimely appeal to a specialist or a complete refusal of qualified assistance can lead to infertility that occurs if the following factors are present:
- Prolonged testicular ischemia as a result of insufficient blood circulation.
- Increase in testicular temperature, which leads to a violation of the process of spermatogenesis.
- In order for sperm to mature he althy, a temperature of 33 degrees is required.
- As a result of inflammation, the temperature rises to the level of body temperature. As a result, spermatozoa become inactive, their size and shape change.
- As a result of abnormal blood shedding, biologically active substances inhibit the process of spermatogenesis.
- As a result of complications -postoperative lymphostasis or hydrocele.
Methods of treatment of varicocele
One, but not the only, treatment is varicocelectomy. Is the operation dangerous?
Varicocele can be detected at the first stage, then the only thing required is to change your lifestyle and limit physical activity.
To normalize intra-abdominal pressure, it is worth carrying out periodic prevention of constipation. Doctors categorically forbid lifting heavy objects, moving sharply, running.
In order to treat varicocele, surgery is performed only at the second and third stages of the disease. The following surgical interventions may be performed:
- Vein embolization, cleaving or ligation.
- Plasty and sagging testicle lift
- Surgical removal of a varicocele.
Affected veins may be excised or embolized. Three accesses are possible:
- Subinguine access.
- Invaginal access.
- Retroperineal.
Modern urology uses laparoscopic surgery. They do not involve a large incision, and the affected segment can be removed with small probes. These operations belong to the field of microsurgery. After the intervention, tiny scars may remain, healing within a week after the operation. The patient after laparoscopy can return to the previous way of life in ten days. Doctors will require only restriction of physical activity. itconfirm the disease varicocele reviews.
Prevention of varicocele
Measures to prevent varicocele are all simple. A few rules should be followed, and this will reduce the risk of disease:
- It is necessary to consciously approach physical activity and not forget about rest.
- Must have a regular sex life.
- Restricting alcohol consumption would be good.
- You need to eat well and in a balanced way. First of all, this will help to avoid constipation.
- You should fully rest and sleep.
- It is important to take vitamins in the off-season.
- Timely medical check-up, especially if alarming symptoms appear.
Reviews
Surgical intervention to treat pathology causes a lot of positive feedback. Laparoscopy is especially effective. There are practically no scars, complications too.
Risk group
Varicocele is most common in men who are professional athletes, weightlifters, boxers, physically work more than four hours a day, have an acquired or congenital pathology, suffer from thromboembolism or renal vein thrombosis.
We looked at the dangers of varicocele.
