Diagnosis & Treatment of Varicocele

Diagnosis & Treatment of Varicocele for Male Fertility & Health: Expert Urologist in Dubai

What is a varicocele and what are its implications?

Before the birth of a male child, the testicles develop within the abdominal cavity. With each month of pregnancy, the testicles descend downwards and ultimately, at the time of birth, they are located outside the body in the scrotum. The veins which supply the testicle, therefore, come from within the abdomen.

The left testicular vein originates from the renal vein or the kidney’s vein. Most often, the right testicular vein directly comes from the inferior vena cava, or the main body vein. Sometimes, it may come from the right kidney vein or renal vein.

You may have seen people in your family or in the community with big veins in their lower limbs, which are called varicose veins. Varicose veins are a result of blood not flowing freely back away from the body towards the heart. Normally, veins allow blood to flow away from the organ towards the heart, and the backflow is prevented by valves. When these valves are defective, a lot of blood accumulates in the veins, causing them to enlarge. These are called varicose veins.

The same thing sometimes happens in the testicles, where the veins enlarge and a lot of big, dilated veins surround the testicle, causing a varicocele or a varicose vein of the testicle. The reason why varicoceles form is unknown, but they are more commonly seen on the left side of the body, where the left testicular vein reaches the kidney vein or the renal vein. This indicates that blood is flowing backward towards the testicle, causing the veins to enlarge.

When do varicose veins of the testicle or varicoceles develop?

Varicoceles develop at the time of puberty. Generally, children may present with signs of swelling in the scrotum, leading to a diagnosis of varicocele. Very rarely, varicoceles progress with time. Most often, the size of the varicocele is determined at the time of diagnosis, usually in puberty.

How do we grade varicoceles?

The simplest way to grade varicoceles is by performing an ultrasound scan of the scrotum while the patient applies intraabdominal pressure. If there is backward blood flow into the scrotum, it is classified as a Grade 1 varicocele.

If, during a physical examination, a slight cough impulse is detected when the patient coughs and this is confirmed by ultrasound, it is classified as a Grade 2 varicocele.

If the veins are visibly enlarged, appearing like a bunch of worms in the scrotum, it is classified as a Grade 3 varicocele.

If the varicocele is so large that it affects the function of the testicle, leading to a reduction in testicle size, it is classified as a Grade 4 varicocele.

What is the importance of a varicocele?

Varicoceles are very common in the community, especially in Grade 1 and Grade 2, and most often, these do not affect an individual in any way.

How do varicoceles affect a male patient?

When blood accumulates in the veins around the testicle, the weight of the scrotum increases, sometimes causing a feeling of heaviness and discomfort by the end of the day. Normally, the testicles are positioned outside the body to maintain a lower temperature than the body temperature.

However, when testicular veins enlarge, the testicle becomes surrounded by warm blood, increasing its temperature to match body temperature. Sperm production is very temperature-sensitive, and an increase in temperature can negatively impact sperm production.

The second effect of a varicocele is infertility.

Among couples experiencing infertility, 10-20% of cases may be due to a varicocele. A large varicocele can affect both the quality and quantity of sperm production due to increased temperature.

The third effect is a reduction in testicle size.

Large varicoceles can affect the blood supply to the testicle, causing the testicle to shrink. If both testicles are affected, this can impact hormonal production, leading to decreased libido and sexual performance.

In summary:

• Small testicular varicoceles may not present with any symptoms.
• Larger varicoceles can cause a dragging pain in the testicle.
• Severe varicoceles can lead to infertility.
• Ultimately, varicoceles can also impact the hormonal function of the testicle.

Varicoceles are a fairly common problem in urological practice. If a person notices an enlargement of the scrotum, pain in the testicles, fertility issues, or concerns related to hormonal production and libido, they should consult a urologist.

It is important to understand that varicoceles are common, but they should only be treated if there is a specific indication. The diagnosis of a varicocele alone does not necessarily require treatment—this decision is made based on specific indications determined by the urologist.

What are the Treatment of Varicocele options?

Over the years, various treatment methods have been recommended. Currently, the most effective and safest surgical treatment for a varicocele is microscopic ligation of the surgical veins through a small groin incision. This minor procedure allows for quick recovery, requires minimal time away from work, and has good results.

About Dr. H Sanjay Bhat – Best Urologist in Dubai

Dr. H Sanjay Bhat, a renowned Indian urologist, is a Senior Consultant Urologist at Al Zahra Hospital Dubai, Al Barsha, Dubai. He specializes in microscopic ligation of the surgical veins, a highly effective treatment for varicoceles performed through a small groin incision. As one of the best urologists in Dubai, Dr. Bhat has extensive experience in treating male infertility, varicoceles, and other complex urological conditions. His urology and reproductive health expertise make him a preferred choice for patients seeking advanced, minimally invasive surgical treatments.