1016 Urology

Varicocele is one of the diseases that men experience but stay reluctant to talk about, decrease the quality of life and may lead to infertility if not treated early…

We asked frequently asked questions about varicocele to Assoc. Prof. Basri Çakıroğlu, M.D., an Urologist from Hisar Intercontinental Hospital.

Table of Content

  • What is varicocele?
  • What are the signs of varicocele?
  • How is it treated?

What is varicocele?

“Varicocele” implies accumulation of venous blood around the testes due to dilatation of testicular veins and resultant palpability of the veins in the subcutaneous tissue.

The temperature of male testicular organs is 2-3 degrees lower than the body temperature. The temperature increases due to pooling of blood around the testicles and it has negative effects on sperm production and it may even entirely stop production at a certain extent and impair motility and structure of the sperm. This leads to male infertility.

While the condition is detected in 15-25% of male population, it is one of the most common problems in infertile men – the incidence is 40%. On the other hand, the prevalence of varicocele is 80% in men with an acquired type of infertility, called secondary infertility. These patients may not be able to have a second child after the first one.

What are the signs of varicocele?

While recognizable signs are present in most patients, they usually visit our clinic with complaint of pain caused by physical activities or standing up for a long time. The pain usually occurs late at night and disappears when the patient wakes up in the morning.

Diagnosis of varicocele is made through a careful examination by hand (palpation) while the patient is in standing and lying positions in a warm room. However, the diagnosis can be verified with color ultrasound scan, if the patient is overweight, skin of the scrotum is too thick and examination results are uncertain. While it is more common in the left testicle due to direct connection between the left testicular vein and the renal vein, varicocele can also develop on the right side.

How is it treated?

Surgical correction is unnecessary for many patients with varicocele, if infertility, volume loss of testicles or pain is not present. Surgical treatment should be performed for patients with impaired sperm parameters and patients with clinical varicocele. Varicocele may also cause pain. While management of pain cannot be guaranteed, pain disappears in many cases treated with microsurgical techniques and other surgeries focused on management of pain.

Hydrocele (swelling of one or both bags due to fluid collection in membranes surrounding the testicles) is the most common complication that occurs following varicocele surgeries.

Injuries of testicular vessels, bleeding and wound site infections are other important complications.