Varicocele


You've heard of varicose veins — those swollen veins that sometimes
show up in the legs. You've probably heard your grandma and her old lady
friends talking about their varicose veins and never thought twice
about them.

But hopefully you've never heard your grandma mention a varicocele,
which is also a swelling of the veins. A varicocele happens just to
guys, and you probably won't sit around and talk about it with your
pals. That's because it occurs not in the legs but in a place a bit more
private and a lot more tender — the scrotum. It's generally harmless
and basically the same kind of thing as varicose veins in the legs. But
what exactly is a varicocele and how do you get rid of it?

What Is a Varicocele?



In all guys, there's a structure that contains arteries, veins,
nerves, and tubes — called the spermatic cord — that provides a
connection and circulates blood to and from the testicles. Veins carry
the blood flowing from the body back toward the heart, and a bunch of
valves in the veins keep the blood flowing one way and stop it from
flowing backward. In other words, the valves regulate your blood flow
and make sure everything is flowing in the right direction.

But sometimes these valves can fail. When this happens, some of the
blood can flow in reverse. This backed-up blood can collect in pools in
the veins, which then causes the veins to stretch and get bigger, or
become swollen. This is called a varicocele (pronounced: var-uh-ko-seel).Who Gets Them?



Although they don't happen to every guy, varicoceles are fairly
common. They appear in about 15% of guys between 15-25 years old, and
they mostly occur during puberty. That's because during puberty, the
testicles grow rapidly and need more blood delivered to them. If the
valves in the veins in the scrotum aren't functioning quite as well as
they should, the veins can't handle transporting this extra blood from
the testicles. So, although most of the blood continues to flow
correctly, blood begins to back up, creating a varicocele.

An interesting fact is that varicoceles occur mostly on the left side
of the scrotum. This is because a guy's body is organized so that blood
flow on that side of the scrotum is greater, so varicoceles happen more
often in the left testicle than the right. Although it's less common,
they can sometimes occur on both sides.

What Are the Signs and Symptoms?



In most cases, guys have no symptoms at all. A guy might not even be
aware that he has a varicocele. However, if there are symptoms, they
tend to occur during hot weather, after heavy exercise, or when a guy
has been standing or sitting for a long time. Signs include:

• a dull ache in the testicle(s)
  
• a feeling of heaviness or dragging in the scrotum
  
• dilated veins in the scrotum that can be felt (described as feeling like worms or spaghetti)
  
• discomfort in the testicle or on that particular side of the scrotum
  
• the testicle is smaller on the side where the dilated veins are (due to difference in blood flow)
  
• What Do Doctors Do?
  
  
  
  It's a good idea to get a testicular exam regularly, which is
  normally part of a guy's regular checkup. In addition to visually
  checking for any unusual lumps or bumps, the doctor generally feels the
  testicles and the area around them to make sure a guy's equipment is in
  good shape and there are no problems.
  
  A testicular exam may be done while a guy is standing up so that the
  scrotum is relaxed. (Some abnormalities like a varicocele can be more
  easily felt in a standing position.) The doctor checks things like the
  size, weight, and position of the testicles, and gently rolls each
  testicle back and forth to feel for lumps or swelling. The doctor also
  feels for any signs of tenderness along the epididymis, the tube that transports sperm from the testicles.
  
  The spermatic cord is also examined for any indication of swelling.
  If the doctor suspects a varicocele, he or she might confirm suspicions
  by using a stethoscope to hear the blood flowing backward through the
  faulty veins or might even use an ultrasound, which can identify
  malfunction of the veins and also measure blood flow.
  
  Do Varicoceles Cause Permanent Damage?
  
  
  
  Although there is no way to prevent a varicocele, it usually needs no
  special treatment. A varicocele is usually harmless and more than
  likely won't affect a guy's ability to father a child. Some experts
  believe, though, that in some cases a varicocele might damage the
  testicle or decrease sperm production. In those cases, a doctor will
  probably recommend surgery.
  
• What If the Doctor Finds a Varicocele?
  
  
  
  Varicoceles are generally harmless, but if there is any pain and
  swelling the doctor may prescribe an anti-inflammatory medication to
  relieve it. If the varicocele is causing discomfort or aching, wearing
  snug underwear (like briefs) or a jock strap for support may bring
  relief. If pain is persistent and support doesn't help, the doctor may
  recommend a varicocelectomy (a surgical procedure to remove the
  varicocele).
  
  A varicocelectomy is done by a urologist (pronounced: yoo-rah-luh-jist),
  a doctor who specializes in urinary and genital problems. The procedure
  is usually done on an outpatient basis (meaning there's no need for an
  overnight stay in hospital). The patient usually receives general or
  local anesthesia. Then, the doctor simply ties off the affected vein to
  redirect the flow of blood into other normal veins.
  
  In some cases, instead of surgery, doctors can pass a plastic tube
  into the vein that's causing the varicocele and treat the problem by
  causing a blockage in the blood flow to the enlarged vein. Talk with
  your doctor about whether this form of treatment might be an option for
  you.
  
  After surgery,
  the doctor probably will recommend that a guy wears a scrotal support
  and places an ice pack on the area to bring down any swelling. There may
  be discomfort in the testicle for a few weeks, but after that, any
  aches and pains will go away and everything should be back in full
  working order