What is Varicocele? How Does It Form?
What is a Varicocele?
Varicocele is a condition of venous insufficiency where the veins in the scrotum (a skin-covered sac that holds the testicles) get enlarged due to poor functioning of the valves located in the veins. It is a common condition in males between 15-25 years of age and is prevalent among 15-20% of the male population, being the most common cause of infertility.
How does it form?
Varicoceles are caused due to vein abnormalities in the scrotum. The valves within the veins regulate blood flow to and from the testicles. Due to the abnormalities caused by a defective valve in the vein, blood circulation becomes irregular, causing the blood to pool. This results in an enlargement or inflammation of the veins in the scrotum.
This condition most commonly takes place during puberty, when the testicles are experiencing rapid growth. In about 85% of the cases, varicoceles are found on the left side of the scrotum. In rare cases, it can also exist on both sides of the scrotum.
Causes & Symptoms of Varicocele
- Blockage in the spermatic cord
- Injury around the scrotum or testicles
- Infections like epididymitis
- Drinking water while standing
- Exercising without any protective gear
- Puberty
- Visible lump or swelling in the scrotum
- Dull and recurring pain in the scrotum
- Swelling and intensifying pain around the scrotum
- Visibly twisted veins in the scrotum
- Feeling of heaviness in the testicles
- Infertility
Varicocele Diagnosis & Evaluations
Self-diagnosis
Varicocele is a fairly common condition among males. In most cases, people might have no symptoms at all, which also serves as a reason for it to be left untreated.
There are certain cases where people are even unaware that they are suffering from a varicocele. But, it can be a matter of concern, usually after performing a strenuous activity/heavy exercise or after prolonged standing and sitting hours.
The signs that might indicate that you may need a treatment are as follows:
- Dull pain in the scrotum/testicles
- A feeling of heaviness or dragging in the scrotum
- Visibly twisted veins in the scrotum
- Infertility
- Visible lump or swelling in the scrotum
- Discomfort in a testicle or a particular side of the scrotum.
Diagnosis by doctor
If you consult a urologist to get rid of your varicocele, he/she will carry out a physical examination of your condition, which might help the doctor to feel the non-tender mass above your testicle. If it is still not diagnosed, the urologist might use a procedure called of Valsalva maneuver, where you might be asked to stand, take a deep breath, and hold it while you bear down. Test
- Valsalva Maneuver: The Valsalva maneuver is a breathing technique that is directed by the doctor in order to diagnose problems related to the autonomic nervous system. In this diagnostic test, the urologist will ask you to breathe out strongly through your mouth while holding your nose tightly closed in a standing position. This will exert increased pressure in your chest and will help the doctor detect the presence of any abnormal enlargement of the veins in the scrotum.
- Scrotal/Doppler Ultrasound: This test uses sound waves to create images of the organs inside your body. The doctor will be able to classify your varicocele based on the size of the lump, as this test helps in determining the direction of blood flow in your scrotal veins and can help the doctor find out how large the veins in the scrotum are.
Scrotal Infrared Digital Thermography: This is a non-invasive diagnostic method that helps in the detection of a varicocele in its initial stages. This test measures the temperature of the skin surface around the scrotum. Thermography of the scrotum is quite useful in diagnosing low-grade varicoceles and is also used in follow-up diagnostic tests after operative treatment of the condition.
What are the Grades of a Varicocele?
Grade 1
In this stage, the varicocele is not visible and can only be felt when the patient is straining, which is why the physician uses a Valsalva maneuver.
Grade 2
At this stage, the varicocele can be felt at rest. Although it is not visible, it can be detected without using a Valsalva maneuver.
Grade 3
This is the stage where the varicocele becomes clearly visible and can lead to complications that would involve discomfort and infertility.
What Happens if Varicocele is Left Untreated?
If a condition of varicocele is left untreated, it can worsen over time, leading to an aggravation of the symptoms that can make it more difficult for you to carry on with your daily activities. Untreated varicoceles can lead to a variety of complications that can include the following:
- Fertility problems
- Testicular atrophy or shrinking of the testicles
- Azoospermia
- Hormonal imbalance
- Erectile dysfunction
When to consult a doctor for Varicocele Treatment?
A condition of varicocele does not lead to life-threatening complications and might not be an immediate medical emergency. However, it can possibly lead to a number of complications that include infertility and reduced testosterone production that can lead to problems like metabolic syndrome, osteoporosis, and diabetes.
If you are experiencing any of the signs and symptoms of varicocele and are aware that it is affecting your fertility or sperm production, you should right away consult with a varicocele surgeon for varicocele treatment without delay.
Questions to Ask Your Doctor About Varicocele
- What is the most likely cause of my symptoms?
- Will this condition affect my fertility?
- What are the treatment options available to me?
- Are there any possible complications I am yet to face?
- I have these other health conditions. How can I best manage both together?
- Are my symptoms likely to get worse without treatment?
- What are the chances of the treatment improving my fertility?
- Are there any chances of my condition recurring after treatment?
Varicocele Treatment Cost in India
The cost of a varicocele treatment in India may range anywhere from ₹40,000 to ₹70,000. However, this cost should not be considered an absolute as it may vary from person to person depending on multiple factors such as doctor’s fee, type and location of the hospital chosen to undergo the treatment, cost of medications, and amount to be paid for diagnostic or other laboratory tests.
Insurance Coverage
Most of the surgeries at Pristyn Care are covered under insurance. But insurance coverage also depends on the type of insurance you choose and the place you opt it from. An insurance team from Pristyn Care will check all your insurance papers and will let you know whether the treatment for varicocele can be covered under insurance or not.
Myths and Facts about Varicocele
Myth 1: Varicocele is caused by taking cold showers.
Fact: No, taking cold showers does not lead to varicocele. However, in certain cases, it might cause the scrotum to contract.
Myth 2: A varicocele is a rare condition.
Fact: Varicocele is a common condition. Between 10-15 percent of all men develop varicocele at some point in their life.
Myth 3: Decreased fertility is the only complication that can arise from a varicocele.
Fact: While infertility is the prime concern, varicoceles can cause other complications as well. They can be the cause of reduced testosterone production, which can lead to complications like metabolic syndrome, osteoporosis, and diabetes.
Myth 4: Lifestyle changes do not affect fertility.
Fact: Certainly not. Leading a sedentary lifestyle and smoking may have a significant impact on the semen parameters and sperm health of a man and can worsen the condition of a varicocele.
Myth 5: Varicocele is not dangerous and can be left untreated.
Fact: A varicocele is not usually life-threatening and might not even require immediate treatment. However, given the complications it can cause, it is always a wise choice to consult a urologist and seek proper treatment.
Prevention of Varicocele
The fact is, there is no way to prevent a varicocele. However, you might be able to restrict the condition from getting worse by taking certain measures that include- maintaining good health, following a healthy diet, drinking enough water, and avoiding smoking. In order to make sure that your condition does not escalate any further, you should also avoid wearing tight-fitted clothes. Improving and maintaining the health of your veins can help you deal with the pain and discomfort.