One of the reasons for a low sperm count according to some experts is a varicocele. A varicocele is a swollen varicose vein in the scrotum – usually on the left side. The condition occurs because blood pools in the varicose testicular veins since the valves in the veins are leaky and do not close properly. Reason for infertility associated with varicocele is unclear. Varicocele is the enlargement of the spermatic cord in the scrotum. The spermatic cord is the cord that holds the arteries and veins that supplies the blood to and from the scrotum. Sometimes a varicocele causes pain or atrophy (shrinkage), or fertility problems.
Varicocele is a common cause of male infertility — a condition where the veins in the spermatic cord in the scrotum become abnormally dilated and tortuous.You’ve heard of varicose veins — those swollen veins that sometimes show up in the legs. You’ve probably heard your grandma and her old lady friends talking about their varicose veins and never thought twice about them.
In all guys, there’s a structure that contains arteries, veins, nerves, and tubes — called the spermatic cord — that provides a connection and circulates blood to and from the testicles. Veins carry the blood flowing from the body back toward the heart, and a bunch of valves in the veins keep the blood flowing one way and stop it from flowing backward. In other words, the valves regulate your blood flow and make sure everything is flowing in the right direction.
But sometimes these valves can fail. When this happens, some of the blood can flow in reverse. This backed-up blood can collect in pools in the veins, which then causes the veins to stretch and get bigger, or become swollen. This is called a varicocele (pronounced: var-uh-ko-seel).
Signs and symptoms of Varicocele
Symptoms of a varicocele may include:
• Dragging-like or aching pain within scrotum.
• Feeling of heaviness in the testicle(s)
• Atrophy (shrinking) of the testicle(s)
• Visible or palpable (able to be felt) enlarged vein, likened to feeling a bag of worms.
Causes of Varicocele
The idiopathic varicocele occurs when the valves within the veins along the spermatic cord do not work properly. This is essentially the same process as varicose veins, which are common in the legs. This results in backflow of blood into the pampiniform plexus and causes increased pressures, ultimately leading to damage to the testicular tissue. Varicoceles develop slowly and may not have any symptoms. They are most frequently diagnosed when a patient is 15–30 years of age, and rarely develop after the age of 40. They occur in 15-20% of all males, and in 40% of infertile males.
98% of idiopathic varicoceles occur on the left side, apparently because the left testicular vein runs vertically up to the renal vein, while the right testicular vein drains directly into the inferior vena cava. Isolated right sided varicoceles are rare, and should prompt evaluation for an abdominal or pelvic mass (see secondary varicocele, below).A secondary varicocele is due to compression of the venous drainage of the testicle. A pelvic or abdominal malignancy is a definite concern when a right-sided varicocele is newly diagnosed in a patient older than 40 years of age. One non-malignant cause of a secondary varicocele is the so-called “Nutcracker syndrome”, a condition in which the superior mesenteric artery compresses the left renal vein, causing increased pressures there to be transmitted retrograde into the left pampiniform plexus The most common cause is renal cell carcinoma (a.k.a. hypernephroma) followed by retroperitoneal fibrosis or adhesions.
How Common Varicocele Is?
Varicocele is the commonest cause of low sperm count with poor motility (oligoasthenozoospermia). Fifteen percent of the general male population: Forty percent of men evaluated for primary infertility and Fifty percent of men evaluated for secondary infertility have varicocele.Varicocele , in fact is the most common identifiable and surgically correctable factor contributing to poor testicular function and decreased semen quality.
How is it Diagonised?
A) Clinical Examination: The doctor examines the patient in the standing posture and feels the spermatic cord – the cord-like structure from which the testis hangs. Varicocele feels like a bunch of worms in a bag. On coughing, this feel gets transiently exaggerated.
B) Color doppler sonography is the most accurate and objective method of detecting and documenting a varicocele
Surgery For Varicoceles Is No Longer Required
If you have been diagnosed with a varicocele, you have more treatment options than you may have been told about. A revolutionary newer procedure called varicocele embolization is a non-surgical alternative to painful varicocele surgery.Varicocele embolization has been successful at eliminating varicoceles for thousands of men, and can have you back to your active lifestyle in only a few days. Many men choose this non-surgical alternative because it does not involve general anesthesia, incisions in the scrotum, or sutures.