VARICOCELE /enlargement of testicle veins /Anotaion:
The reason for this lesion is weakness of the venous vessel wall.
The reason for the etiology of this lesion is not clear (there is no connection with passed traumas, definite sport, long standing, etc.). It is known only that it is due to weakness of venous vessel wall, but what it is due to, it is not completely established.
Varicocele is diagnosed most often at accidental exam or exam due to sterility. When it is very big, it may cause pain in testicle or cosmetic defect over it.
The damage by varicocele on spermatozoa formation, generally speaking, is due to blood stasis, resulting from varices. It is interesting, that in spite of the existence of varicocele, some patients have preserved insemination ability and the science can not reply why spermogram in most of the men with varicocele is damaged and in other it remains normal.
If there is pain, cosmetic defect or sterility, operation is recommended. If no operation is made in sterility, in future there will be no danger about the sexual abilities of the man, but slight pain may appear in the same testicle. Without operation, the possibility to have pregnancy after medication is 10% (medication lasts 3 months at least).
Operation is middle by volume (preferred method is microsurgical one). Incision of 5-7 cm is made in groin above the testicle and the dilated vein is interrupted. Duration is 20-30 minutes with local anesthesia. Hospitalization is 1 hour. Working ability is restored after 5-7 days and physical drills are permitted after 15 days. Sick note is issued for 30 days. The danger from the operation is that in 2-3% may appear inflammation of wound or testicle and in 1-2% is possible to appear water in testicle sheath, which necessitates repeated small operation. This intervention does not affect potency.
Pregnancy is expected between 6 and 12 months after the operation and the probability is 60%. If after 6-12 months there is no pregnancy, stimulants are prescribed for at least 3 months. Further 3 months are waited to obtain results from the medication and if then there is no pregnancy, then artificial insemination methods are applied (in Vitro, ICSI, etc.)