Varicocele a common cause of male infertility

Thursday, November 8, 2012

Facts about Varicocele

A varicocele is a collection of enlarged, varicose veins that develops in the spermatic cord. Caused by a defective or damage valve that regulates blood flow into the main circulatory system. Blood flow is hampered and enlargement of the vein occurs.


  • A varicocele can occur in one or both testicles

  • Most common in the left testicle (85% more common)

  • More common in men between the ages of 15 and 25 years old (10-20% higher).
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  • Varicocele, a Common Cause of Infertility


  • About 40% of infertile men have a varicocele.

  • About 80% of men with secondary infertility, who have fathered one child but are unable to do so again, have a varicocele.

  • Infertility is common because the blood carried in the dilated vein makes the testes warmer. It is this warmth damaging sperm that is believed to be the cause of infertility. 
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  • Signs and Symptoms of varicocele


  • The majority of men with a varicocele do not experience any symptoms.

  • Most cases are discovered during a physical examination by a doctor i.e. for infertility

  • The testicle may ache

  • There may have a feeling of heaviness in the testicle

  • It may be possible to feel the enlarged vein

  • here are a number of treatments avaiable to treat a varicocele. Treatment depends on symptoms and seriousness of the condition.

    Treatment in Cases with No Symptoms or Mild Symptoms

    A scrotal support or supportive underwear may be the only treatment required.
    Varicocele Ligation

    Surgery is recommended for men with a varcocele where pain, damage to the testicles, atrophy or where treatment is required for sterility. The procedure is surgical ligation (tying off) of the distended veins. This can be carried out under a general or local anesthestic. Keyhole surgery is sometimes available and results in a smaller scar. Surgery takes about 45 minutes and is performed as day surgery.

    About two weeks away from work will be required but this depends on the type of work. A scrotal support will be required for some time after surgery.

    Treatment Complications following Varicocele Ligation

    Complications include infection, hematoma (blood clot formation), injury to the scrotal tissue or structures, injury to the artery that supplies the testicle. Re-emergence of the varicocele occurs in between 0.6 and 45% of cases

    Embolization of the Varicocele

    Performed under a local anesthetic, a small incision is made into the right side of the groin, through which a small wire is passed into the large vein in the leg. The wire is guided into the veins and drains the left scrotum. A small metal coil is placed in the vein to block it off, effectively doing the same job as surgical ligation. The procedure is usually on an out patient basis. The advantages of embolization include minimal risk of damage to the testicular artery so testicular atrophy is rare. There is a very small risk of developing a hydrocele.
    Reocurrance of varicocele after this procedure is between 4% and 11%.

    Complications of Embolization of Varicocele


  • Migration of the coil out of the vein

  • Allergic reactions to the x-ray contrast dye

  • Bleeding from the right groin where the wire is inserted
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  • Returning to Fertility following Surgical Intervention for Varicocele
    It takes about 90 days for a sufficient quantity of new sperm to be produced to permit fertilization.50% of men who have a varicocelectomy to correct infertility father children within a year. 5% to 20% who recieve treatment for varicocele have a recurrance of the condition.

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