The varicocele is the presence of varicose veins in the testicles , a dilation of the veins that come out of these. These testicular varices are one of the main causes of correctable male infertility . It can affect both testicles although it is more common in the left, being of greater length than the right one.
Varicocele, causes and symptoms
Varicocele is caused by an absence or failure of the valves of the veins. These act as gates, allow the blood to rise freely and prevent it from coming back down towards the testicle.
In most cases varicocele does not produce symptoms. It is diagnosed after a genital examination performed on patients with infertility problems.
Other times it can cause pain, discomfort or feeling of heaviness. When it is very striking causes deformities that affect the aesthetics of the testicle (symptomatic varicocele). It can present as thickening in the upper part of the scrotal sac, classically defined as "worm sac" which are the dilated testicular veins forming varices.
Decreases the amount and mobility of sperm
Testicular varices may produce an increase in temperature, lack of oxygenation, and compression clogging of the onset of the seminal pathway. In addition, waste elements from the kidney or adrenal gland can reach the testicle and act as toxic. All of these effects may lead to decreased production and / or quality of spermatozoa. There is a smaller amount of them ( Oligozoospermia ) along with a decrease in mobility ( Astenozoospermia ).
Another possible consequence is the increase of oxidative stress in the testis which results in a fragmentation of the sperm DNA, which causes the inability to fertilize the spermatozoon or repeat abortions .
Varicocelectomy, the treatment of varicocele
The treatment of varicocele consists of ligating the veins of the testicle at the level of the groin ( varicocelectomy ). There are different surgical techniques, nowadays because of their low relapse rate, subinguinal microsurgery, the technique of choice. Another type of treatment is percutaneous embolization, but with higher relapse rates.
With varicocele surgery, the aim is to improve seminal quality and the fertilizing capacity of spermatozoa, increasing pregnancy rates, both naturally and in assisted reproduction techniques