Varicocele Treatment

What is Varikosel?

Varikosel is a condition characterized by swelling that occurs in one of a man's testicles. This swelling develops due to the enlargement of the veins in that region, and it is usually painless. Every cell in the human body follows a certain order. When this order is disrupted, certain diseases develop. Varikosel occurs as a result of blood flowing in the reverse direction through the testicular veins.

The structure of these veins is similar to varicose veins. Although it may not be visible to the naked eye in some cases, it can be noticeable in others. When this condition is researched, it is generally found to occur during puberty. This period is the critical time when young people develop varikosel. In rare cases, it can occur in children under 10 years of age. The development of symptoms after puberty is quite rare.

Research shows that this condition most commonly occurs in the left testicle. Although varikosel is not painful, doctors typically do not recommend treatment. However, if the following symptoms are present, a doctor may consider treatment necessary.

• If swelling in the testicles is accompanied by pain,
• If the testicles show no growth or are actually shrinking,
• If there is increased heat in the testicles, a doctor should be consulted and treatment should begin. Since this condition can negatively affect sperm production, it may cause infertility in the future. For these reasons, if treated early, the recovery rate is high.

According to research, varikosel is found in approximately 15% of men worldwide, making it a relatively common condition.

What Are the Symptoms of Varikosel?

Varikosel is a condition affecting the reproductive organs in men. This condition usually occurs without pain and without symptoms. However, in some cases, the following symptoms may occur:

• Pain in the left testicle when standing, with a feeling of relief when lying down. These pains are usually quite painful.
• Visible shrinkage in the person's left testicle,
• Symptoms such as affecting fertility and causing infertility may require a doctor's consultation.

What Are the Causes and Types of Varikosel?

Although the exact cause of varikosel is not clearly known, it is believed to be caused by rapid growth in the sexual organs of adolescents during puberty.

This condition is examined in three stages depending on the individual.

• Grade 1 Varikosel Symptoms: The swelling in the person's testicle can only be felt by touch when the person strains or performs the Valsalva maneuver.
• Grade 2 Varikosel Symptoms: The swelling in the person's testicles can be felt by hand without straining or effort.
• Grade 3 Varikosel Symptoms: The swelling in the person's testicles can be detected by visual inspection without requiring touch. This indicates a more advanced stage of varikosel.

In addition to these three grades, there is also a subclinical stage called "subclinical varikosel," which has no symptoms yet and can only be detected by ultrasound. At this level, swelling cannot be detected either visually or by physical examination, but can be revealed by imaging methods.

Several factors that may play a role in causing this retrograde blood flow in the testicular veins include:

• Structural defects in the valves inside the veins,
• A mass or tissue growth that puts pressure on the veins,
• Blood clots forming inside the veins.

How Is Varikosel Diagnosed?

The process begins when a person who suspects they have varikosel visits a urology specialist for examination. The examination is a physical examination, and the doctor performs the examination while the patient is standing since the veins are more visible in this position.

Both testicles are examined, and the doctor asks the patient to perform straining movements such as coughing or the Valsalva maneuver for more detailed examination. Following the doctor's physical examination, an ultrasound image may also be obtained. A more precise diagnosis is made based on this imaging result. This condition is usually seen in the left testicle but can rarely occur in the right testicle. In some cases, kidney diseases or tumors have been found to trigger varikosel.

What Is Sperm Analysis (Spermiogram) in Varikosel?

Since this condition can cause infertility in individuals, sperm count is typically checked following diagnosis. Patients diagnosed with the condition undergo sperm analysis twice at intervals of 1-3 weeks.

Healthy individuals should have at least 15 million sperm cells per milliliter. If this number is in the range of 5-10 million, additional blood tests are performed on the patient. If the sperm count is less than 5 million, genetic testing is performed.

What Are the Treatment Methods for Varikosel?

Varikosel usually occurs in adolescent and young adult males. Treatment is rarely required for this condition, but in some cases, a doctor may consider surgical intervention necessary. This necessity often stems from significant shrinkage of one of the testicles.

Following treatment, an improvement is seen in the quality of the person's sperm and resolution of infertility.

• In the initial stage, pain that occurs when standing often resolves when lying down. In cases where pain accompanies the condition, surgical intervention may involve vein ligation.
• After the doctor's examination, the adolescent patient's sperm quality and count are checked. If abnormal findings are detected in the testicles and test results show abnormalities, vein ligation or occlusion surgery is performed.
• The medical term for vein ligation surgery is surgical ligation, while the minimally invasive method of entering the vein and blocking it is called percutaneous venous embolization.

Varikosel Monitoring (Observation) Can Also Be an Option

When the swelling is small and painless and there are no problems with sperm parameters, the doctor may recommend regular follow-up and monitoring instead of initiating direct treatment. During this period, the patient continues with periodic examinations to see if there are any changes in the varikosel.

Can Varikosel Be Treated Without Surgery?

When varikosel disease progresses, surgery is the only solution. However, when surgery is not desired, the patient is anesthetized with local anesthesia, and the vein is entered using the angio method and occluded. This procedure is called embolization.

Can Medication Be Used for Varikosel?

There is no medication that completely eliminates varikosel. However, under medical supervision, pain relief medications can be used temporarily to reduce pain and discomfort. These medications do not address the underlying cause of the disease; they only provide symptomatic relief.

In addition to medication therapy, lifestyle modifications such as wearing supportive underwear, avoiding prolonged standing or sitting, and regular exercise may be recommended to support blood circulation. A healthcare professional should be consulted to determine the most appropriate approach for each individual.

What Is Varikoselectomy (Varikosel Surgery)?

The surgical procedure performed when surgery becomes necessary is called varikoselectomy. This procedure can be performed under general or local anesthesia. The surgeon makes a small incision in the groin area and identifies and ligates the enlarged veins with the aid of a microscope.

Varikoselectomy is subdivided into different techniques:

• Open varikoselectomy: The traditional method in which a larger incision in the groin area allows access to the enlarged veins.
• Microsurgical varikoselectomy: A more contemporary technique that uses a microscope for better visualization of the veins and aims to minimize damage to surrounding tissues and vessels. This technique may be preferred especially for large or complex varikosel cases.

The choice of technique to be applied is determined by the doctor considering the severity of the varikosel, the patient's symptoms, goals, and general health status.

Recovery after surgery is usually completed within a few weeks. During this period, mild pain and swelling of the scrotum are normal. As with any surgical procedure, there are some risks such as bleeding, infection, or nerve damage, although these risks are rare.

What Are the Symptoms of Bilateral Varikosel?

Bilateral varikosel is a condition in which varicose-like vein enlargement is seen in both testicles. Symptoms vary from person to person and may include:

• Pain in the testicles ranging from mild aching to severe pain, which may increase with physical activity or prolonged standing,
• A feeling of heaviness and visible enlargement of the testicles manifesting as swelling,
• Fertility problems resulting from effects on sperm production and quality.

In some individuals with bilateral varikosel, no symptoms may be present; such cases are usually discovered during routine examinations. If symptoms are present and causing discomfort or affecting fertility, a doctor should be consulted.

Is Varikosel a Genetic Condition?

Research suggests that a genetic component may play a role in the development of varikosel. It has been observed that varikosel occurs more frequently in individuals with a family history of the condition; some studies suggest that a genetic basis may be present in a significant proportion of cases.

However, genetic factors alone are not decisive; hormonal imbalances and lifestyle-related factors may also play a role in disease development. Although the genes responsible for varikosel have not yet been definitively identified, it is thought that multiple genes may be involved in this process. Advances in research in this field could contribute to the development of improved diagnostic and treatment approaches in the future.

Is Varikosel Treatment Performed with Hospital Admission?

Whether varikosel treatment is performed with hospital admission depends on the severity of the condition and the treatment method selected. In most cases, treatment can be performed on an outpatient basis. Non-surgical approaches such as scrotal support and pain relief can be managed at home.

In cases requiring surgical intervention, varikoselectomy can generally be performed on an outpatient basis; however, an overnight hospital stay may be necessary in some cases. This decision is determined by the patient's overall health status, the scope of the procedure to be performed, and the doctor's evaluation.

How Long Does Varikosel Surgery Take?

Varikosel is a condition that usually occurs on one side, most commonly the left. During treatment of this condition, the surgery takes approximately 40-45 minutes.

Although rare, bilateral varikosel can occur in some cases, and surgery time can extend to 1-1.5 hours in these situations.

During the post-operative period, mild pain and swelling of the scrotum may occur; this is considered normal and usually resolves within a few weeks. Most patients are able to return to daily life and work within 1-2 weeks after surgery.

Varikosel Treatment Costs in Turkey

Varikosel treatment, like the treatment of all types of diseases, is performed successfully in Turkey. The instruments and treatment methods used in the treatment of this condition are in line with the latest technology.

Particularly, foreign nationals living abroad prefer to undergo varikosel treatment in Turkey. The wide and high-comfort hospital facilities, the high-quality education and expertise of doctors in their fields, and the affordable treatment costs in Turkey are among the reasons for this preference.

If you wish to obtain information about varikosel disease, ask any questions you may have, and learn about treatment costs, you can contact us.

Sources Used:

https://emrebakircioglu.com/blog/sperm-sayisi-kac-olmali

https://www.medicalpark.com.tr/varikosel-nedir-tanisi-ve-tedavi-yontemleri-nelerdir/hg-1340

https://drahmethakan.com/varikosel/#Varikosel_Ameliyati_Fiyati