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A varicocele is an abnormal dilation of the veins surrounding the testicle, similar to varicose veins. It can cause discomfort and, in some cases, affect male fertility.
When indicated, it can be treated by surgery or minimally invasive techniques to interrupt blood flow in these veins.
A varicocele is the dilation of the veins surrounding the testicle within the scrotum (the loose skin that holds the testicles). These veins drain the testicles, carrying blood, but when the valves in the veins, which allow for proper blood flow, malfunction, the veins dilate and blood accumulates, causing swelling.
Most often, varicocele occurs unilaterally, that is, only in one testicle (usually the left one due to the position of the testicular vein), but there are cases of bilateral varicocele in which both testicles are affected.
Varicoceles usually form during puberty and develop over time. They are more common in tall, thin boys.
Although varicoceles don't usually cause symptoms, some patients report discomfort, pain, a "bag of worms" sensation, or pricking pains when standing for long periods, during strenuous physical activity, or in hot weather, similar to what happens with varicose veins in the legs. This is because the blood has to work harder to circulate properly due to the force of gravity.
Since the testicle needs specific conditions for its proper development, these varicose veins near the testicle can alter its growth and function, affecting future fertility in some cases.
In older men, one possible cause is the presence of a kidney tumor. For this reason, patients over 40 with a varicocele should request a thorough examination to rule out any type of tumor.
The exact cause of varicocele is unknown. It is due to a slowed flow of blood through the spermatic veins, which collect blood from the testicle, probably due to a problem with the venous valves.
Some studies suggest that it has a hereditary factor, so boys whose parents or brothers have suffered from this venous inflammation in the testicles are more likely to experience the same.
Since it does not present symptoms, it is usually detected by chance during a routine evaluation or fertility examination in adult patients.
In children, the diagnosis is made by physical examination in consultation and by performing a Doppler ultrasound of the scrotum, in which the size and development of the testicles and the presence of varicose dilatations that increase when abdominal pressure increases (Valsalva maneuvers) will be assessed.
Generally, varicocele does not need to be treated, as in many cases it poses no risk or its existence is not even noticed.
The urologist may suggest annual checkups to monitor for any changes and recommend surgery in the following cases:
The surgical procedure to treat varicocele can be part of a fertility treatment plan. It involves sealing the affected vein to redirect blood flow to healthy veins. This is an outpatient procedure, and the patient can usually go home the same day.
There are two approaches to this surgery :
Microscopic varicocelectomy. The surgeon makes a tiny incision in the lower groin and, using a powerful microscope, identifies and ligates several small veins. The procedure lasts 2 to 3 hours.
Laparoscopic varicocelectomy. The surgeon uses a video camera and several surgical instruments connected to probes that pass through very small incisions in the lower abdomen. Because the network of veins is less complex above the groin, there are fewer veins to ligate. The procedure lasts 30 to 40 minutes.
As an alternative to surgery, embolization can be performed. This less invasive procedure uses image guidance and a catheter to place small coils and/or a liquid substance into a vein to divert blood flow away from a varicocele. The procedure takes about an hour. Recovery is short and involves only mild pain.
We treat our patients at the ROC Chamberí clinic and in the HM Hospitals network of centers in Madrid: Sanchinarro, Montepríncipe, Madrid Río, Rivas, Puerta del Sur, Nuevo Belén, Policlínico HM Moraleja and Nuevo Norte.
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We treat our patients at the ROC Chamberí clinic and in the HM Hospitals network of centers in Madrid: Sanchinarro, Montepríncipe, Madrid Río, Rivas, Puerta del Sur, Nuevo Belén, Policlínico HM Moraleja and Nuevo Norte.
Coming soon
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