Men with testicles have a congestion of veins that form a groinlike plexus. When these veins are subjected to varicose dilatation, varicocele develops. A similar disease is not uncommon, occurring in 12-15% of men of any age. The adolescents are most prone to this pathology, because sexual maturation is one of the provoking factors of pathology. In 9 out of 10 cases of pathology, the varicocele is diagnosed on the left, which is caused by the asymmetry of the circulatory system. Varicose veins of both testicles occur in 7% of cases, and right-sided varicocele is diagnosed only in 3% of cases of pathology.
Than it is dangerous varikotsele
Varikotsele refers to very artful pathologies. In the course of the development of the disease, there is a disturbance in the nutrition of the affected testicle, causing his tissues to gradually become atrophied. The venous network of dilated vessels disrupts heat transfer and contributes to the creation of so-called. The greenhouse effect, which provokes the testicular hyperthermia.
For the development of normal full spermatozoa, a temperature of 32.5-34.3 ° C is needed. Because the varicocele temperature in the testicle increases, the spermatogenesis is broken or completely stopped. The absence of spermatogenesis on the background of neglected varicocele leads to the development of male infertility, and the prolonged absence of proper nutrition is fraught with irreversible testicular atrophy.
Clinical picture of the left-sided varicocele
Usually, men rarely find this pathology, and most of those who still notice changes in the size of the left testicle experience cosmetic discomfort rather than physical discomfort. The clinical picture of pathology depends on the intensity and stage of its development. The disease begins to be hidden, there are no pathological manifestations. Gradually varicocele progresses, in the scrotum there is a slight soreness from time to time.
Varicocele is often characterized by asymptomatic development, so pathology is often detected during a scheduled physical examination or examination for other reasons. When the pain symptoms become persistent and strongly pronounced, the man is already forced to go to the doctor, because the pain in the scrotum, groin and perineum becomes painful. If a man is engaged in physical activity, he goes around a lot, and also during sexual intercourse painful manifestations tend to intensify.
Degrees of development of pathology
Specialists distinguish several degrees of left-sided varicocele:
- Subclinical grade - characterized by the absence of symptoms, patient complaints do not bother. But with ultrasound, the varicocele is easily detected;
- At the second stage of development, a palpable examination of the scrotum in the standing position of the patient indicates the expansion of the veins. Testicles occupy an asymmetric position. Some patients are concerned about soreness and burning sensation in the scrotum;
- The third stage of pathology is characterized by a distinct palpation of swollen veins. The left side of the scrotum becomes noticeably larger, although visually the veins are not visible. The patient complains of intense traumatic pain in the groin and perineum;
- In the fourth degree, a cluster of dilated veins is clearly visible even without palpation. The slightest physical overstrain or long activity standing or sitting provokes the occurrence of severe pains, prone to intensification in the evening.
Causes of the disease
Experts often disagree about the causes of left-sided varicocele. Disputes are reduced to the following assumptions regarding the root cause of the pathology:
- Anomalies in the development of venous valves, their absence or functional insufficiency. Such factors lead to an inverse blood flow, causing venous expansion and transformation;
- If the vein of the testicle enters the vein of the kidney at a right angle. This phenomenon provokes difficulties with blood circulation, which leads to the formation of a left-sided varicocele;
- Anomalies of venous development during the intrauterine period;
- Weakened venous walls;
- Structural features of the vascular structure;
- Chronic hypertension in the veins;
- With the direct connection of the renal vein to the artery, the risk of developing varicocele increases;
- Various kinds of neoplasms;
- Chronic form of diarrhea or constipation leads to an increase in venous pressure in the low-dose region, which contributes to the development of varicocele.
Often, the development of varicose veins in adult patients is associated with constantly high loads on the muscle tissues of the press, which often reveals a disease of people with severe physical activity and professional athletes.
Diagnostic procedures
An experienced specialist often has enough traditional medical examination to determine the presence of varicocele. To confirm the diagnosis, additional diagnostic procedures are usually prescribed such as:
- A thermographic study aimed at determining the temperature of the testicle at the site of venous expansion;
- Phlebography - X-ray study using contrast agents, intended for studying the vascular condition;
- Ultrasound Doppler study is aimed at determining the degree of blood loss and the violation of blood supply to the tissues of the scrotum and testes;
- Spermogram is performed to detect abnormalities in the processes of sperm formation.
Therapeutic approach
The varicocele can be cured only by a surgical approach. Conservative methods will require significant costs, not only monetary, but also temporary, and the result will be zero. Surgery is mandatory for men who suffer from a lack of fertility or painful pain. If the pathology does not progress, and its manifestations do not cause a man any discomfort or infertility, then the need for surgery disappears.
The decisive factor in the appointment of an operation is the presence of male infertility. If a man plans to become a father in the future, surgical intervention is inevitable. If paternity is not planned, and the pathology itself does not cause problems, then it is quite possible to abandon the operation.
Usually, surgical intervention to eliminate varicocele is applied to men of reproductive age. Older men, if the pathology does not cause complications and pains, it is not necessary to perform an operation.
Operative intervention is carried out in several ways.
- When part of the vasculature affected by varicose extensions is removed. The necessary site is cut off and the vascular plastic is made, thanks to which the full restoration of all the functions of the vessels takes place. Such an intervention is called microsurgical revascularization. The advantage of such an operation is the fact that the blood flow in the testes tissues is restored almost immediately after the operation. The probability of developing relapse is practically absent, because pathologically altered sites with dilated veins are completely removed. Among the shortcomings of this procedure is its high cost, the high complexity of the manipulations performed and the long rehabilitation period in the hospital.
- There is another way of surgical treatment of varicose veins of the left testicle. It involves a complete excision of the dilated vessel. The result of such an operation is a complete cessation of the outflow of blood, resulting in the body beginning to rebuild, seeking new ways for the bleeding from the testicle. Gradually there is a restoration of blood circulation. Surgical activity in such an operation is minimal, so intervention refers to simple operations. After the procedure, the patient is for some time in the clinic, although the rehabilitation period takes much less time than with revascularization. An additional advantage of such treatment is its low cost. Among the disadvantages especially high probability of recurrence varicocele and non-physiological operation.
There are no specific specific measures for the prevention of varicocele. Therefore, the main measures for timely detection of the disease are timely urological examinations after reaching puberty. If the pathology is not found, then the probability of its occurrence in the future is minimal.
