Varicocele – one of the leading causes of infertility in men. Let’s look at varicocele in a nutshell – its definition, causes, symptoms, types of surgery, and how it leads to infertility.
What is a varicocele?
A varicocele refers to the abnormally enlarged vein along the spermatic cords inside the testicles. (It’s similar to varicose veins in legs when veins bulge due to the buildup of blood.)
Varicoceles are said to affect about 10% of all males, but as not all varicoceles lead to infertility, only about 40 to 50% of affected men are infertile or their testicles have decreased function.
35% of all oligozoospermia (low sperm count and low sperm quality) cases and 78% of secondary infertility cases are caused by varicoceles .
Causes of varicoceles
Varicoceles are believed to be the result of problems in the valves of the spermatic cords that carry blood to the testicles. When the valves don’t work properly, blood in the body doesn’t flow properly and starts to build up in the veins.
Usually, varicoceles form during puberty when the testicles are undergoing rapid growth. Varicoceles seldom develop in men over the age of 40. They usually develop in the left testicle as a result of the position of the left testicular vein. However, even if only one testicle is affected by varicoceles, this can affect the sperm production in both testicles and lead to infertility.
Varicoceles and infertility
According to a study conducted by the WHO, varicoceles are linked to the decreased function of the testicles, resulting in infertility. A total of 9,034 males from 24 countries presenting as a partner of infertile couples took part in the study. Varicoceles was found in 25.4% of the men who abnormal semen, while varicoceles were found in 11.7% with normal semen.1
After surgery was performed to treat the varicoceles, about 51 to 78% of the patients saw their conditions improve. For men with azoospermia (inability to produce or ejaculate semen), 20 to 30% were able to produced semen after the varicocele surgery was performed.
The study found that as a result of varicoceles, 35% of men unable to have their first child while 69% of men struggled with secondary infertility. Other studies have shown that the conditions of men with varicoceles improved greatly after undergoing surgery, and on the other hand, not undergoing surgery caused the motility and number of the sperms to decrease further, lowering the overall quality of the sperms.
Varicocele treatment: Types of surgery
Surgery to treat varicoceles differs depending on the severity of the man’s condition. Below are the types of surgery used to treat varicoceles:
Varicocelectomy (Conventional Open Surgery)
This is the most common form of surgery. An incision will be made on the belly or below the groin area and the problematic veins will be tied up by the doctor. This is an outpatient procedure and most men are able to go back to a normal life and about their usual activities 3 to 4 days later.
Microsurgery is carried out using a microscope, and the varicoceles are cut and stapled close or stitched up. As this surgery only takes less than an hour for one scrotum, and as the incision is small, recovery time is short.
This is a surgery that requires an incision to be made on the belly, and the veins are extracted. Laparoscopy is considered not as effective as open surgery techniques and riskier.
Coil Embolization, Radiologic Balloon Occlusion or Radiologic Ablation (Non-Surgical)
This method is considered a non-surgical procedure that isn’t commonly performed. A coil or balloon catheter is used to reach the vein and then alcohol is injected to make the vein nonfunctional. This is considered a procedure that is as effective as surgery.
Do a simple check on your testicles now. Are your scrota of the same size? Is there a lump or swelling in your scrotum? Is the skin very wrinkled and can you see veins that are enlarged or twisted?
If your answers to these questions are all “Yes”, you might want to take a trip down to the hospital and get yourself checked.
Facing the possibility and infertility square in its face
Knowing that you could be infertile might be a depressing thought, but it’s not the end of the world, yet. Though it might take some time, don’t run away from the problem, face it square in its face, and with surgery, your condition might just improve. Stay positive and this mentality will help you through the tough times.