When you look at your testicles, does one side seem to hang a little more than the other? Or do you sometimes feel a strange ache or heaviness in the area of your testicles ? The cause of these things may be a common but not very common condition called `Varicocele`. Don't worry, this is not life-threatening. Today, we will explain everything about this in a simple way, as if you were talking to a friend.
What is Varicocele? Let's understand it simply.
Simply put, Varicocele is when the veins or blue veins in your scrotum become swollen, enlarged, and twisted.
Imagine, some of us have varicose veins in our legs, right? We call it `Varicose veins`. The same thing happens to the veins in the scrotum. The scrotum is a pouch of skin behind the penis. Your testicles are protected inside this pouch. There are some veins that carry dirty blood from these testicles back to the heart. When these veins become swollen and enlarged, we call it `Varicocele`.
Most often, this condition occurs in the left testicle. This is due to a slight difference in the way blood vessels are arranged in our body. However, rarely, it can occur on the right side or on both sides.
How do you know if you have a varicocele? Symptoms
Many people with Varicocele do not show any symptoms, but some may experience these symptoms.
| Symptom | Description |
|---|---|
| Testicular pain | It feels more like a heavy, dull ache than a sharp pain. This pain can be worse when you stand all day or exercise. The pain usually subsides when you lie down. |
| Swelling of the testicle | The testicle on one side may appear larger than the other. |
| Knots that get caught in the hand | If the varicocele is large, it may feel like a "bag of worms" when you touch the top of the testicle. |
| Testicular atrophy | The testicle on the side with the varicocele may be smaller in size than the healthy side. |
| Difficulty having children | If you have difficulty conceiving a child after trying for at least a year without any protection, Varicocele may be the cause. |
What does it mean to feel like a "worm riot"?
This is the most common metaphor used to describe a varicocele. When you touch the scrotum of a man with a large varicocele, it feels like a bunch of knotted, coiled noodles under the skin. That's why it's called a "bag of worms." However, a small varicocele is not visible or palpable.
Why does this Varicocele occur? What is the cause?
Doctors still haven't found a single, definitive cause for this, but the main theory is that it's caused by the valves in the veins that carry blood up from the testicles not working properly .
Think of these valves as small gates that open only in one direction. Their job is to stop the blood from flowing back down after it has gone up against gravity. So if these gates don't close properly, the blood flows back down and collects inside the veins. Over time, this blood fills up, the veins swell, and a 'Varicocele' is formed.
This condition often first appears during adolescence, especially during puberty . This is because the blood supply to the genitals increases during this time, and any problems with these veins become apparent.
Is this serious? Will it affect having children?
First of all, it should be said that `Varicocele` is not a life-threatening condition, such as cancer.
However, the main issue that can be serious is the effect on fertility . Varicocele has been found to be related to about 40% of the causes of male infertility . However, this does not mean that everyone with a Varicocele cannot have children. Most people have children without any problems.
How does a Varicocele affect childbearing?
The exact mechanism for this is still being researched, but the main theory is that it is due to increased temperature .
- Testicular temperature: To produce healthy sperm, the temperature of the testicles should be slightly lower than our normal body temperature.
- Blood accumulation: In a varicocele, blood accumulates in the veins, causing the temperature around the testicles to rise above normal levels.
- Effects on sperm: This increased temperature can negatively affect sperm production, sperm quality, and motility. This is what causes infertility.
In addition to this, several other complications can occur due to `Varicocele`:
- Low testosterone levels: Testosterone is the main male hormone. It is produced in the testicles. Varicocele can impair the function of the testicles and reduce the level of this hormone. This can lead to decreased sexual desire, muscle weakness, and mental stress.
- Azoospermia: This is a rare condition. Azoospermia is the absence of sperm in the semen. This can occur in severe cases of Varicocele.
The most important thing is that if you have a question about adopting a child, see a doctor immediately and talk about it.
How does the doctor diagnose this? (Diagnosis)
When you go to see a doctor, he will first ask you about your symptoms and then do a physical examination. During this examination, he will ask you to stand up.
While your doctor is examining your scrotum, he or she will ask you to hold your nose and mouth closed, tighten your stomach muscles, and exhale as if you are trying to breathe. This is called the Valsalva maneuver. This increases the pressure inside your abdomen, which can make the veins look more bulging if you have a varicocele. This will allow the doctor to feel it and confirm it.
In addition, the following tests may be performed to confirm the diagnosis:
- Scrotal Ultrasound Scan: This is the most commonly performed test. This painless scan can clearly see the condition of the veins in the scrotum and how the blood flows.
- Semen analysis: If you are having difficulty conceiving, your doctor may recommend this test. This involves taking a sample of your semen and testing it for the number, quality, and motility of sperm.
- Blood test: This helps to check if your hormone levels, especially hormones like testosterone, are normal.
Are there types of Varicocele? (Ranking)
Doctors classify a varicocele into grades based on its severity. This is very important in determining treatment.
| Grade | Description |
|---|---|
| Grade 0 | The smallest type. Not palpable during a physical examination. Can only be detected with an ultrasound scan. |
| Grade I | It doesn't usually get caught in the hand. It only gets caught in the hand when doing the Valsalva maneuver (squeezing) mentioned earlier. |
| Grade II | Even without the Valsalva maneuver, the doctor can feel it by touching it while standing, but he can't see outside. |
| Grade III | The largest type. It is clearly visible from the outside and fits comfortably in the hand. |
How is it treated?
Whether or not to treat it depends on your symptoms, the severity of your Varicocele, and whether you have any problems having children.
At home and general management
If you have a small varicocele and it's not causing you any pain or fertility problems, you probably won't need any treatment. But if you're experiencing pain or discomfort, you can try these things:
- Supportive underwear: Wearing tight, supportive underwear or a jockstrap can help reduce pain, especially when exercising or standing for long periods of time.
- Ice: When you are in pain, you can get relief by placing an ice pack wrapped in a towel on the scrotum for about 10-15 minutes. (Never put ice directly on the skin).
- Painkillers: You can take painkillers (NSAIDs) like `Ibuprofen` on the advice of your doctor. However, you should definitely consult a doctor before using these to make sure they are suitable for you.
Surgery (Varicocelectomy)
If you have severe pain due to a varicocele, if your testicles have shrunk, or if it is affecting your ability to have children, your doctor may recommend surgery.
This surgery is very simple. The surgeon identifies the problem, swollen veins, cuts them, and seals them. This stops the blood from flowing through those veins, and the blood starts flowing through other healthy veins. This is a successful surgery. It can take about 6 weeks to fully recover from the surgery.
What is the difference between Varicocele and Hydrocele?
Some people confuse these two conditions because they occur in the testicles.
- Varicocele: This is a problem with the veins . The veins in the testicles swell.
- Hydrocele: This is a fluid- filled sac. Hydrocele is caused by fluid accumulating around the testicles. This is most common in young infants.
The symptoms and treatments for both are completely different, so if you have a problem, it's important to see a doctor to find out exactly what it is.
Take-Home Message
- Varicocele is a very common condition among men. There is no need to be ashamed or afraid of it.
- Most people do not experience any symptoms, and in such cases, no treatment is needed.
- This is not a life-threatening disease, but it can affect fertility.
- If you have testicular pain, swelling, a lump in your arm, or are having trouble conceiving, see a doctor immediately.
- There are simple management methods as well as highly successful surgeries as treatments. Therefore, it is important to seek proper medical advice.
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