Varicose Veins: What Should You Know About Them?

Varicocele is the main cause of male infertility, which occurs in as many as 40% of infertile patients. However, in most cases, the condition does not present any symptoms or cause difficulties or complications. You will learn more about this disease by reading today’s article

Varicocele is a disease that affects both men and women. However, its rate is significantly higher among the male part of the population. It involves the swelling of the seminal veins, which makes the testicles less supplied with blood.

In women, it affects the ovarian vein. In the further part of the text you will learn the most important information about this disease.

This condition is the leading cause of male infertility. A publication in the Mexican College of Urology Bulletin (available in English) states that this disease accounts for 40% of male infertility cases.

Medical websites run by experts, such as the MSD Manual, say the disease is extremely widespread. Available data suggest that it affects 15% to 20% of men. However, there are no statistics on its prevalence in women.

The condition is usually diagnosed between the ages of 15 and 25. It is extremely rare in men over 45 years of age. If it does, it can lead to complications, as if it is left untreated.

Varicocele: what should you know about them?

This condition is a narrowing of the veins in the spermatic cord, which prevents enough blood from reaching the testicle. In women, the condition is a narrowing of the ovarian vein.

As explained in an article in Legal Medicin of Costa Rica (available in English), this stenosis leads to the formation of varicose veins in the pelvic area and causes pelvic congestion syndrome (PCS).

Varicose veins can be primary or secondary. Primary varicose veins appear due to anatomical problems that block the outflow of blood from the vasal canal.

Secondary varicose veins, on the other hand, appear as a result of other factors, such as the presence of a retroperitoneal tumor, malignant neoplasm of the kidney, cirrhosis of the liver with portal hypertension, or retroperitoneal fibrosis.

In most cases, varicose veins occur outside the testicles. External varicose veins occur only in a small percentage of patients. Besides, they most often affect the left testicle. However, that doesn’t mean they can’t appear on the right or both.

Possible complications

In most cases, varicoceles do not present any symptoms. However, when they occur, they may cause discomfort and minor pain, especially when standing or exercising.

Patients usually only start treatment when symptoms appear. According to the information posted on the Mayo Clinic, they may include a variety of therapeutic or surgical techniques. The same source states that the main complications of untreated varicoceles include :

• Testicular Atrophy : Causes a significant reduction in testicular size. The normal functioning of the gonads is disturbed, which can lead to premature infertility or erectile dysfunction as a result.
• Partial or complete sterility : Varicose veins can lead to an increase in temperature in the testicle. This prevents the normal production of sperm and can lead to complete sterility or problems with conception.

Another complication that occurs as a result of untreated varicocele is chronic pain. This pain can restrict or even prevent some hip movements. Usually responds well to commonly available painkillers.

Complications and their treatment

Most often, varicose veins are treated with scrotal support and vasoconstrictor medications.  However, if any complications arise, the next step is to perform a surgical ligation. At the same time, your doctor may perform a procedure called testicle embolization.

There may be complications with either method. Below we have described two treatments taught by doctors at the University Hospital Center in Coimbra (Portugal) :

• Removal of varicocele or surgical ligation is an outpatient method which in most cases does not cause any complications. The main risk is damage to the artery that supplies blood to the testicle, but this is very rare. This procedure can also lead to infection, bruising, or damage to nearby tissues.
• Testicular emoblization is a minimally invasive procedure and therefore safer than surgical ligation. The risk of complications is much lower, and the convalescence is much shorter.

Both procedures – embolization and surgical ligation – are 90% effective. The difference is that the former does not require a surgical incision, which significantly reduces the risk.

Other possible risks

As we mentioned earlier, these procedures are usually not associated with serious complications. However, a study published by Translational Andrology and Urology (available in English) indicates that the following complications cannot be ruled out:

• In a small percentage of cases, treatment (both surgical ligation and testicular embolization) does not improve the patient’s fertility.
• Sometimes the procedure is not able to reduce the pain from varicose veins because the veins in the scrotum remain narrowed.
• Rarely, there is a hydrocele formation on the scrotum.
• In rare cases, patients may experience bleeding of varying intensity, which may require another operation.

A visit to the doctor plays a key role

In conclusion, it should be emphasized that if you notice any of the symptoms mentioned earlier and you think you may have varicocele, you should see your doctor.

Regardless of whether you need treatment or not, a specialist will be able to make an accurate diagnosis and dispel any doubts that may arise in your head .