A Varicocele is the enlargement of the vein in the scrotum which drains the testicles. Although the link between infertility and a varicocele has not been proved inconclusively generally speaking, a man with a varicocele will have a lower sperm count, poorer sperm motility and poorer sperm morphology. This does not mean that a man with varicocele is incapable of fathering a child, it just may take longer than average.
A varicocele is similar to varicose veins in the legs - the valves in the veins beside the spermatic cord are not working correctly and this results in the backflow of blood, increased pressure and eventually damage to the testicular tissue. Varicoceles are slow to develop and usually occur during the ages of fifteen to twenty five years and rarely over forty. Forty percent of infertile men have a varicocele.
Mostly a varicocele occurs in the left testicle, this is because the left testicular vein runs up to the renal vein whereas the right hand vein drains straight into the inferior vena cava.
A varicocele will give the following symptoms:
o Infertility
o Shrinking of the testicle
o Feeling of heaviness in the testicle
o Palpable or even visible enlarged vein
If a varicocele is suspected an ultrasound will be conducted. The patient will stand up to increase the pressure in the veins while a Doppler ultrasound measures the speed at which the blood is flowing in the vessels.
The treatment of a varicocele is not straight forward and not without risk. Surgery usually only takes place in cases of infertility or testicular atrophy and usually leads to the return of normal testicular temperature and increased sperm motility and sperm count.
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