What Is Varicocele, The Disease That Can Affect Male Fertility

Jacqueline Carrera, a pediatric surgeon, comments that it usually occurs between the ages of 10 and 17 and there is no defined cause.

It is associated with a congenital condition or due to the malfunctioning of the valves of the testicular veins. To explain it, Carrera compares it to varicose veins in the legs because the valves of the vein in this area do not work and this causes the veins to grow and dilate. The blood remains accumulated in that area.

It usually occurs in the left testicle, probably due to the position of the left testicular vein.

One of the peculiarities of this disease is that it does not cause pain and most of the time it does not have any symptoms other than seeing a group of worm-shaped veins in the testicle, what is observed is that this organ appears larger.

Carrera emphasizes that because of the age at which it occurs, children and young people sometimes do not mention it, and that is why it is important to tell them that any change in their reproductive organs or that one testicle grows more than the other should be reported.

Experts add that men should learn to perform a testicular self-examination, which is positive for detecting varicocele as well as other lesions or problems.

Pain is rarely felt. Occasionally, it may occur after lifting something heavy or making a great effort.

There are usually three degrees of varicocele. In adulthood, it can reach grade two or three, which is where the most complications arise.

This pathology is not common, up to 14 percent of the male population is diagnosed during adolescence, explains Marco Antonio Ortíz Herrera, urologist.

Doctors also explain that this disease is associated with the left side. It is rarely associated with the right side and when this occurs it is important to check it because it could be associated with a kidney tumor or a kidney problem.

More of the consequences

Without proper monitoring, being located in the area where sperm are generated could cause infertility.

Ortiz explains that although this condition occurs during puberty and adolescence, the consultation can take place at any age. Men of mature age come to his office, regularly because their partner is unable to get pregnant and it is important to rule out varicocele as one of the causes.

American urology guidelines always suggest this check-up when an adult man’s spermogram (an analysis that measures semen quality and sperm quantity) is not normal.

Medical literature explains that one of the most common problems that cause infertility is related to a problem in the functioning of the testicles. In some cases, men produce less sperm than normal; this disorder is called oligospermia and the most common cause of this is varicocele.

In a couple that has trouble conceiving, it has been linked to some condition in the man in 30 to 40 percent of cases. The testicles produce and store sperm, which is ejaculated through the penis to send the sperm to the female reproductive tract during sexual intercourse.

The treatment

The most common way to treat this condition is with surgery, although it is not necessary for everyone. Dr. Ortiz comments on the importance of evaluating patients and making a timely recommendation.

Some men have this condition since childhood and it goes unnoticed because it does not affect their fertility and does not cause any problems.

The idea is to see progress in children and adolescents because when they are in grade two or three, surgery may be required.

In adulthood, a spermogram is recommended to evaluate the amount of sperm and make the decision to operate or not, adds Ortiz.

Carrera explains that the interventions are open or laparoscopic to cauterize the veins and prevent blood from accumulating there. Both operations are abdominal; the testicles are never opened, says Carrera.

Laparoscopic surgery is the least uncomfortable. It is performed using a thin tube called a laparoscope, which is inserted into the abdomen through a small incision.

This tube has a camera that sends images to a monitor, allowing the doctor to see inside.

The purpose is for the blood to be able to return normally to the circulatory system.

Recovery is quick and the only recommendation is to avoid blows or strong exercises for a week.

An associated complication is hydrocele or accumulation of a little fluid in the area, but it does not represent a problem.

In adult men, this intervention may improve the sperm count, although it is not a guarantee of pregnancy.

In general, doctors also recommend good habits to take care of the male reproductive system. This includes using contraceptive methods to avoid sexually transmitted diseases and consulting a urologist after age 40 for regular check-ups and to avoid other diseases.