What is a Varicocele? | Varicocele Surgery, Symptoms and Diagnosis

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Varicocele surgery is one of the best microsurgical methods. In this article, we explained what varicocele is, its symptoms and diagnosis.


Varicocele is the event that the veins that drain the dirty blood of the testicle (eggs) in men are wider than normal. In other words, we can define varicose veins in the legs as the similarity in the testicular veins. After puberty (puberty), approximately 15% of men and approximately 35% of those who come with infertility have varicocele. It is the most common correctable cause of male infertility.

What Causes Varicocele?

To answer the question of why varicocele occurs; it is usually seen on the left side. The reason for this is that the veins that drain the dirty blood of the eggs (testicles) discharge into the renal vein and are more right angled. It is also important for family reasons. On the right side, the main veins called vena cava drain into the vein at a more horizontal angle and are less common. So, we have to think mostly it is on the left.

In addition, it can be seen in egg (testicular) cancers or intra-abdominal cancers due to compression of the veins. Especially if it is only on the right side, one should be alert in this direction.

What are the Symptoms of Varicocele?

Varicosal symptoms such as pain hitting the left groin, bag and leg, vascular structures in the left bag (scrotum), infertility, shrinkage and softening of the eggs, and decrease in sexual desire may be present. As I said above, it is the most common correctable cause of male infertility.


Is There a Grade or Type of Varicocele?

It has 3 types and degrees. There is no apparent problem, which we call first degree subclinical, and it is detected by examination or ultrasonography with special maneuvers. This is the lightest type.

Second degree varicocele. Nothing is in sight, but it is detected by inspection without any maneuver. This type is moderately harmful.

Third degree varicose veins are seen from the outside and may cause volume loss in the eggs. This type is the most severe and harmful.

What Harms Does Varicocele Cause?

varikosel ameliyatı

  • It is the most common correctable cause of infertility.
  • Decrease in testicular (egg) volumes and softening in consistency
  • Pain in groin and bags
  • Lack of sexual desire due to a decrease in male hormone (testosterone) level

When Should Varicocele Be Treated?

The most important and common treatment is when the patient is infertile. First, a semen (sperm) test is performed to the patient who comes due to infertility. Decides whether to perform additional tests according to sperm values.

Hormone analyzes are performed when necessary. When the patient has groin pain that does not respond to medication, it should be treated. In addition, if varicose veins have cosmetic (aesthetic) concerns, varicocele treatment should be performed.

How is Varicocele Treatment?

varikosel tedavisi

According to scientific studies, the most valid treatment of varicocele is surgery, and the best-known method is microsurgical varicocele surgery.

In this surgery, there is a chance to connect all the enlarged veins, namely the veins, under the microscope. Its recurrence and complication rate is very low.

In addition, there are other methods such as shrinking the veins with some substances and laparoscopic surgery.

What Are the Success Rates After Varicocele Surgery?

Approximately 35% of those who undergo microsurgical varicocelectomy will get pregnant within one year. 70% sperm (semen) values ​​come to normal. It is reported that semen parameters worsen around 2%.

When it comes to pain, it is seen that the pain disappears in about half of those who are operated only for pain.

Varicocele is diagnosed primarily because of the patient’s suspicion. Second, it happens with infertility. So, the situation we call infertility happens. Accordingly, the patient comes to us. We make the diagnosis because of these investigations. We put this in two ways. One of them is the physical therapy, which is a manual or visual examination. The other is placed because of measuring the vessels there with color Doppler ultrasonography.

Varicocele can cause some problems in testicles. What kind of troubles are they? Harmful substances in the blood come to the testicle due to varicocele and cause some disorders in the testicle. On the other hand, by increasing testicular temperature, it causes infertility by affecting sperm morphology, sperm structure, sperm count and all sperm parameters.

Varicocele causes some changes in the testicles, especially by increasing the temperature or causing some harmful substances in the blood to come to the testicle, causing infertility. Therefore, it reduces sperm production. It causes changes in sperm functions and infertility.

There is no drug treatment for varicocele today. However, there is information in an effective way about some drugs used in this hemorrhoid. However, varicocele treatment is not a medication but surgery. Microsurgical varicocelectomy method is the best way to do this.

It is mostly seen in the patient group as a result of the absence of children, although a year has passed in married couples. So it is seen in men of reproductive age. Secondly, it occurs in children or adolescents. These also need to be treated. It can also be seen in adults. However, if it does not cause serious symptoms such as pain, then there is no need for treatment. Or if there is no expectation of a child, there is no need for treatment.

Prof. Dr. Abdullah ArmağanUrology Specialist

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