Today Thursday Nov 26, 2020

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varicocele


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The scrotum is a skin sac that holds the testicles inside. The sac also contains the arteries and veins that carry blood to the gonads. Dysfunction of a vein in the scrotum can lead to varicocele. In fact, varicocele means the dilation of the internal veins of the scrotum, also called the ivy.

Varicocele is a very common male disease that affects 15% of adult men and 20% of adolescents. Of course, in general, it mostly happens between the ages of 15 and 25.

This disease usually occurs in adulthood and is more likely to occur in the left testicle, and this is due to the same anatomy of the right and left sides of the human body. Varicocele rarely occurs in both testicles, but the possibility is not zero. It should also be noted that not all types of varicocele can affect sperm production.

Varicocele occurs only in the scrotum and is very similar to leg varicose veins. This problem can lead to reduced sperm production and quality, which in some cases can lead to male infertility and shrinking testicles.


Detection method

Many men do not know they have varicocele because they often have no symptoms. But varicocele is actually very common and affects about 10 to 15% of men.

 

signs

Although many patients with varicocele have no symptoms, they actually have many common symptoms that are often overlooked. Some of these symptoms include:

* The size and twisting of the vessels (veins) inside the scrotum, which looks like a worm sac.

* Feeling of heaviness, tightness and pain in the skin of the testicles

* A lump or nodule inside the testicle that is painless

* One testicle is larger or heavier than the other.

* Pain that intensifies when standing but is relieved by lying down.

* Reduce the number of sperm

* Pain that gets worse after strenuous activity.

* Pain that is exacerbated by the heat of the air.

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reasons

The male reproductive system, the meningeal or spermatic cord, carries blood in and out of the testicles. Although it is not yet clear what the main cause of varicocele is, many experts believe that varicocele forms when the arterial valves inside the spermatic cord block proper blood flow. As a result, the arteries dilate to compensate for this problem. Dilation of blood vessels can damage the testicles and make it harder for men to reproduce.


When can varicocele be dangerous?

This condition can be dangerous and requires definitive treatment if it causes the following problems:

- sterility:

Studies show that the percentage of infertility in men with varicocele is much higher than men who do not have varicocele. Of course, the reason is still unclear. But there is a theory that the reason for the rise in temperature of the scrotum due to the accumulation of blood, which can lead to a decrease in the number and quality of sperm and ultimately infertility. Even if one of the testicles has varicocele, the temperature of both testicles may rise due to the accumulation of blood in the dilated arteries.

Research shows that 25% of men who have a problem with their sperm tests have varicocele, and treatment can improve the quality of their sperm. Keep in mind that not all men with varicocele are infertile and can have children.

It is now recommended that varicocele be treated only if it has the following characteristics.In addition to being identified in the scan, it also shows itself in experiments.The sperm count is low and the person has been infertile for 2 years.There is no other rationale for infertility.

 

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- Small testicles:

If a teenager develops a large varicocele, his or her testicles may not grow enough. In these cases, your doctor may recommend that your testicles be measured annually. However, the testicles may be smaller than normal forever, which can be a cause of infertility.

-Sudden varicocele in older men:

Sudden onset of varicocele can be a sign of a blockage in one of the large abdominal arteries. This condition occurs only in men over the age of 40, which is very rare.


treatment

Varicocele may not need treatment at all. Many men with varicocele can have children without any treatment. However, surgery should be performed if varicocele causes pain, testicular dryness, and infertility, or if a person is seeking assisted reproductive techniques.

Varicocele surgery involves closing a problematic artery and pumping blood to other healthy arteries. If a person is infertile, surgery can improve sperm quality or treat infertility.

Symptoms of severe varicocele in adolescents include dry testicular skin, pain, or abnormal test results. Varicocele treatment generally improves sperm characteristics, but it is not yet clear whether failure to treat varicocele can lead to poor sperm quality.

Surgery can have side effects such as:

* Produces fluid around the testicles

* Varicocele recurrence

* Infection

* Artery damage

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Surgery

There are three ways to treat varicocele:

1.Varicocelectomy

Open varicocelectomy is performed under anesthesia or local anesthesia. The surgeon accesses the varicocele from the abdomen through the groin, or in some rare cases. Using ultrasound and surgical microscopes, the problematic vessel is closed and blood flows through the rest of the healthy vessels. After surgery, the patient feels very little pain and can soon resume his daily activities.

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2.laparoscopy

In this procedure, the surgeon makes a small incision in the abdomen and through that hole, a small instrument is inserted into the body that closes the artery.

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3.Percutaneous embolism

The radiologist inserts a tube or catheter into the body through the neck or groin. Surgical instruments pass through the tube, and the surgeon uses springs and chemicals to injure and eventually close the vessel. This type of surgery is minimally invasive and can be performed on an outpatient basis. The recovery period for this type of surgery is also very short.


Postoperative care

After surgery, the patient may feel pain in the groin for 3 to 6 weeks. Also, a person's testicles and groin may become swollen and bruised, which will go away after 3 to 4 weeks.

The patient can probably return to work 2 to 3 days after laparoscopic surgery, depending on the job. If the patient's job involves strenuous activity or lifting heavy objects, he should refrain from doing it for at least a week. If you have had open surgery, going back to your daily routine and work may take longer.

It is best to use protective shorts available in pharmacies for up to 2 weeks after surgery.