You’ve probably heard of varicose veins, those swollen veins that sometimes appear in the legs.
But maybe you’ve never heard of a varicocele, which is also a swelling of the veins. Only men have varicoceles. This is because they do not appear on the legs but in a more intimate and sensitive area: the scrotum. They are usually harmless and are basically the same type of problem as varicose veins in the legs.
But what exactly is a varicocele and how can it be eliminated?
What is a varicocele?
All men have a structure called the “spermatic cord” (which contains arteries, veins, nerves and tubes) that allows blood to circulate to the testicles. Veins carry blood from the body back to the heart, and a series of valves in the veins keep the blood from flowing in the same direction and prevent it from flowing backwards. In other words, the valves regulate blood flow and make sure it always goes in the right direction.
But sometimes these valves fail. When this occurs, some of the blood flows in the opposite direction. This blood can pool in one area and cause the vein to stretch and enlarge, or swell. This is called “varicocele“.
Who has varicoceles?
There is no way to prevent a varicocele. Although they are quite common, not all men have them. This is because, during puberty, the testicles grow rapidly and need to receive more blood flow. If the valves in the scrotal veins are not working as well as they should, the veins cannot properly transport this extra blood. Therefore, while most of the blood continues to flow in the proper direction, a certain amount begins to accumulate and forms a varicocele.
Varicoceles appear most frequently in the left area of the scrotum. This is because men’s bodies are organized in such a way that blood flow to that side of the scrotum is greater; Therefore varicoceles occur more often in the left testicle than in the right. But, although it is not so common, varicoceles can appear on both sides.
What are the signs of a varicocele?
In most cases, boys have no symptoms. They may not even realize they have a varicocele. When symptoms are present, they usually appear during hot weather, after strenuous exercise, or when a child has been standing or sitting for a long time.
Among its signs are the following:
- a dull pain in one or both testicles
- a feeling of heaviness in the scrotum
- feeling of dilated veins in the scrotum (described as the presence of worms or spaghetti)
- discomfort in the testicle or one side of the scrotum
- the testicle is smaller on the side where the dilated veins are located (this is due to the difference in blood flow)
How are varicoceles diagnosed?
It is advisable to have a testicle examination periodically, which is part of the boys’ regular check-ups. In addition to visually examining the area for unusual lumps, the health care professional may feel the testicles and the area around them to make sure they are fit and there are no problems.
The examination of the testicles can be done while the boy is standing so that the scrotum is relaxed. (Some abnormalities, such as varicocele, are easier to detect when standing.) The doctor will examine characteristics such as the size, weight, and position of the testicles, and move the testicles back and forth to look for lumps or swelling. The doctor also looks for pressure and touch sensitivity in the epididymis, the tube that carries sperm from the testicles.
The spermatic cord is also examined for signs of swelling. If your doctor thinks there may be a varicocele, he or she may order an ultrasound, which can measure blood flow and identify veins that are not working properly.
How are varicoceles treated?
Most varicoceles do not need special treatment. Varicoceles are usually harmless and most likely will not affect a boy’s ability to have children later.
But if there is pain or swelling, your doctor may prescribe an anti-inflammatory medication to relieve it. If the varicocele causes discomfort or pain, wearing tight underwear or jockstraps may offer relief.
If the doctor thinks there is a varicocele in the testicle or if the pain continues and the suspensor does not relieve it, surgery called varicocelectomy. This procedure is carried out by a urologista doctor who specializes in urinary and genital problems. The urologist will explain the different ways to perform a varicocelectomy and recommend the most appropriate approach for the patient.
The procedure is usually outpatient (this means you do not need to stay in the hospital overnight). The patient may receive local or total anesthesia. The doctor then simply closes the affected vein to redirect blood flow to normal veins.
In some cases, instead of surgery, doctors pass a plastic tube through the vein with the varicocele and treat the problem by blocking blood flow to the enlarged vein. Talk to your doctor to find out if this treatment could be an option for you.
After surgery, your doctor will likely recommend using a scrotal support and a cold compress on the area to relieve swelling. There may be discomfort in the testicle for a few weeks, but after this time, the pain will disappear and everything should return to normal.
