Testicular varicocele is the name given to the condition which affects the draining of the veins of the testis. Varicoceles occur when the pampiniform plexus (P.P.) veins become enlarged. The P.P. is a network of small veins in the spermatic cord. It is thought that these veins surround the artery and reduce the temperature of the blood flowing into the testis.
In a varicocele, these P.P. veins become bigger and zigzag, as the defective valvular mechanism in the drainage forces the blood flow to slow down, which affects the temperature regulation of the testis. Varicocele is often heredity, as there is a 57% chance that first-degree relatives (sons, brothers and fathers) may be affected by the condition.
Testicular Varicocele Causes
The varicoceles form during puberty and often grow large and more noticeable over time. Varicocele veins are fairly common, as it’s estimated between every 10-15 men out of 100 will develop them. Varicocele veins are most common in males aged 15-25.
A varicocele often will not produce any signs or symptoms. It is also very unlikely they will cause you pain. If a varicocele does cause you pain, you may experience:
- A dull and recurring pain in your scrotum
- Noticeably enlarged or twisted veins in the scrotum. This is often described as looking like a ‘bag of worms.
- Increased pain while standing or during physical exertion, which is only relieved when you lie on your back.
- Impaired fertility.
Testicular Varicocele complications
There are several complications that varicoceles may cause. A varicocele may cause shrinkage of the affected testicle, otherwise known as atrophy. The testicles contain the sperm-producing tubules. When damaged by varicocele veins, the testicle begins to shrink and soften. It is unknown why the testicle does this, but these malfunctioning valves allow more blood to pool in the veins. This then causes an increased pressure in the veins, which increases the level of exposure to toxins in the blood that may cause testicular damage.
Varicoceles also can cause infertility. Varicocele veins can increase the local temperature in or around the testicle. This increased temperature can affect sperm formation, movement (motility) and function.
As often varicocele usually have no symptoms, they often require no treatment. Problems with varicocele are often discovered during a fertility examination or during a routine medical examination.
However, if you experience pain or swelling in your scrotum, it is strongly advised that you see a doctor. You should also visit your GP if you discover a mass on your scrotum, notice a change in the size of your testicles, develop a varicocele in your youth, or believe you are experiencing fertility problems.
Can Varicoceles affect fertility?
It is recommended that anyone who has a varicocele and has an interest in becoming a father, should have their paternity assessed with a detailed history, examination, semen analysis and hormone profile. If a man has a normal semen analysis with the presence of a varicocele, there is no immediate indication for any treatment. However, it is important to recognise the progressive nature of varicoceles and the possibility of testicular damage.
It is common to now treat varicoceles, particularly in younger men to prevent further damage to the testis. Varicoceles are treated either surgically or by embolization technique under X-ray control. The surgical procedure is done as a day surgical case and has higher success rates.