Varicocele

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Stoyanov
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Joined: 24 Mar 2018, 16:21

Varicocele

#1 Post by Stoyanov » 01 May 2018, 22:41

Varicocele, not “varicocela”, as some patients of the andrologist sometimes call this pathology, is a varicose veins dilation of the testicles/testis and spermatic cord (a formation consisting of arteries, vas deferens, venous and neural plexus, and lymphatic vessels). The medical term is derived from the words “dilation” (Latin “varix”) and “swelling” (Greek “kele”).

This problem is quite common: it is recorded in approximately 15% (WHO - 11.7%) of the male population and has been known since the beginning of the millennium. Infertile men suffer varicocele in almost 40% (25.4% according to WHO data) of cases, and if it is a question of secondary infertility, the disease has been already recorded in 80% of the episodes.

Frequency of left-sided lesion varies from 80% to 98%, right-sided – from 2.1% to 8.3%, and bilateral lesion – from 2.48% to 78.5%. In children, the disease is rare (0.12%); typically, it starts developing in the puberty period and often remains unnoticed. In men over 50 years old varicocele reaches (according to vast data) 77.3%!

In isolation, this pathology is not dangerous, but it is an important factor in the development of male infertility.

Classification

According to WHO recommendations, varicocele is classified as follows:
• subclinical: the signs of the disease are detected exclusively on Doppler ultrasound or thermography, any symptoms absent;
• I degree: the change in the veins can be observed upon implementation of the Valsalva maneuver;
• II degree: the veins are palpable, but not visible;
• III degree: the vessels are not only palpable, but also their protrusion is evident during visual inspection.
Depending on the zone where the blood flow is impaired, or the vessels have expanded, the following types can be distinguished:
• rhenospermatic (the most common type, up to 85% of all episodes) – a pathology of internal testicular and renal veins;
• iliospermatic – a pathology of the external testicular, iliac veins; and
• mixed varicocele – is the most uncommon type.

Causes of varicocele

The disease may be primary (according to medical terminology, idiopathic) and secondary (symptomatic), depending on whether a different pathology exists (enlarged lymph nodes, tumor, or cysts).

To this day, the causes of varicocele have remained the subject of lively scientific discussions. It is generally accepted that the venous dilation is due to the increased pressure. In this regard, the causes of primary pathology can include the following:
• Venous insufficiency, when the reverse blood flow is not prevented. This condition leads to the fact that the pressure in the veins increases with physical load and vertical position.
• Special arrangement of vessels, renal vein with the upper mesenteric artery, when the renal left vein is compressed. In the standing position due to the natural gravity, such compression is further increased (this is why the pathology is typically formed on the left side).
• During puberty, a sharp increase in inflow of arterial blood to the testicles.

Symptoms of Varicocele

Very often varicocele has no clinical manifestations at all, and therefore, it can be detected during a physical examination accidentally.

In some cases, a weak soreness in the testicle is felt: drawing/ bursting pain that arises under tension or just when the patient is standing.

Sometimes, the patient may complain of the following:
• dropped scrotum, which becomes more pronounced in the heat or during walking
• heavy weight on the scrotum/groin;
• tingling and burning sensation immediately in the testicle, along the spermatic cord;
• irradiation of pain into the thigh, penis, lower back, abdomen, crotch with reinforcement towards the end of the day, with walking and weakening in the supine position, while lifting the scrotum;
• decreased erectile function;
• poor general health, nervousness;
• increased frequency of urination, enuresis (urinary incontinence at night), etc.

Severity of the symptoms depends on the stage of the progression of the disease: at the late stages, pain becomes permanent, and persists in complete rest. Advance varicocele may develop testicle atrophy/hypotrophy (decrease) or swelling (accompanied by an increase in size).

Stoyanov
Администратор
Posts: 43
Joined: 24 Mar 2018, 16:21

Varicocele

#2 Post by Stoyanov » 09 Mar 2024, 15:56

You can get more information about the treatment of Varicocele in the Russian-language forum using Google Translator - https://hron-prostatit.ru/forum/viewforum.php?f=37 - there are more than 30,000 daily users on the forum, you will definitely find the information you need.

But if you want to discuss the treatment of colliculitis in English, please write your questions and thoughts here, I will certainly answer.

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