Varicocele is the result of excessive dilation of the veins carrying dirty blood from the testicles, and the backflow of blood in them. In the testicles that cannot drain the dirty blood sufficiently, sperm production may be impaired due to impaired blood circulation, temperature increase and accumulated toxic substances, and infertility may occur.
Varicocele is caused by abnormal enlargement of the veins draining the testicle and the reverse flow of blood in it.
It is possible to see enlarged veins over the scrotum in men with varicocele. The appearance of such convoluted and large veins in the scrotum should be suspicious of varicocele.
Normally, 12% of all men also have varicocele. After marriage, 50% of these men have a child without any trouble or problem, while the other 50% consult a doctor due to infertility.
The larger the varicocele, the greater its danger. Also, the longer the varicocele has been present, the more damage it will do. For this reason, it is recommended to pay attention to varicocele even in adolescence, and surgery if necessary. Varicocele should be considered in men who sometimes have pain and swelling in their bags or complain that they do not have a child. The diagnosis of varicocele is made by clinical examination. Sometimes it cannot be detected on examination. In this case, ultrasound or Doppler examinations are required.
The treatment of varicocele is surgery. A small incision is made in the inguinal region and the damaged vein is ligated. It is a small operation, and the patient can usually be discharged on the same day and continue his daily activities. It is preferred to use a microscope in surgery.
Varicocele surgery has no significant side effects. Rarely, swelling due to the accumulation of water in the bags is seen, but this is not often seen in careful surgeries. It may be beneficial to administer hormones and/or blood circulation regulators to the patients for 2-3 months following the surgery in order to stimulate the impaired hormone production in the testicles. An improvement should be expected after 3 months at the earliest. Afterwards, check-ups are required at 6-month intervals. In controls, sperm analysis and recurrence of varicocele are investigated. In recurrent cases, reoperation can be performed. The lack of improvement in the sperm analysis does not mean that the surgery was not successful. Studies have shown that although the number of sperm does not change, their quality improves.
In couples who will undergo IVF, checking the male's varicocele first and, if varicocele is present, in vitro fertilization after surgery increases the success even more.
Within 1 year following the varicocele surgery, 1/3 of the patients have a significant improvement in sperm values and they can get their spouses pregnant. While preoperative spermiogram values improve in ninety percent, there may be no change in ten percent. Since having a child depends on many factors belonging to both men and women, other disorders accompanying varicocele should be thoroughly investigated and treated.
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