Do you have Testicular Varicocele? … Could it affect your ability to father children?
Varicocele is the abnormal dilation and expansion of certain veins within the scrotum (= the veins of the testicles), which leads to the reflux of venous blood and reversal of its flow within the same veins that were supposed to propel the blood upwards towards the heart with the help of internal unidirectional valves. But with malfunction ensuing, the venous blood starts to flow downwards towards the testicles … causing a problem called “Varicocele”.
The Varicocele problem is one of the most common problems among men and is present, generally, in about 20% of men and in about 40% of infertile men. In most cases, the cause of Varicocele is some congenital weakness in the venous blood vessel wall and begins to emerge as pathology with puberty and weakness of the vessels wall increases with age.
Usually Varicocele occurs on the left side (60% of cases), and in the left and the right sides together (25%), and it may occur on the right side only in few cases (15%) and in this scenario there is a need for more clinical and diagnostic assessment to rule out the possibility of the presence of extra-scrotal medical problems (= inside the abdomen), leading to Varicocele.
It is noted that the impact of Varicocele varies from person to person, sometimes we find a very large varices, but do not cause any negative changes in sperm count or function, and sometimes we find mild varices that is only discovered through Ultrasound but associated with severe weakness in the sperm viability, either in number or movement, or both.
In spite of constant controversy over the impact of testicular Varicocele over male fertility, it is widely agreed among Infertility Specialists that the increased stagnation of venous blood in the affected veins around the testis is accompanied by a rise in temperature within the testis, which adversely affects the sperm manufacturing process.
Others theories claim that the reflux of venous blood from the renal vein towards the testis carries along certain harmful wastes from the kidney or the supra-renal gland that exerts a harmful effect on the testicular function, yet this theory is still being debated.
Overall, Varicocele can negatively impact sperm count, movement, or both, and may also have an adverse effect on the shape of the sperm leading to sperm deformities which hinder the fertilization process and hence can delay or hamper fertility.
Varicocele is usually diagnosed easily through clinical examination and also it can be detected through Doppler and colored testicular ultrasound. These investigations are highly accurate, fast and literally-speaking; pain-free.
As for getting rid of Varicocele and despite the fact that treatment is based on the surgical intervention, the relentless scientific progress in this area produced advanced minimally-invasive surgical solutions to fix Varicocele, the effective and most recent of which is the microscopic intervention to ligate the abnormal veins through a minute incision of about 3 centimeters through which the dilated veins are tied by the surgical microscope while preserving the integrity of the testicular artery and accompanying lymph vessels.
This minimally-invasive procedure usually takes no more than 45 minutes, and the patient does not need more than a few hours to be discharged from the hospital the same day with speedy resumption of daily life activities shortly afterwards.