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Date of last update: 10/16/2017.

Forum Name: Male Sexual Disorders

Question: Re: Varicocele


 FLAEMT - Tue Aug 08, 2006 1:33 am

Hello to all,

This post is a follow up to my previous post about my testicular pain. To confirm my suspicions, an ultrasound helped to diagnose bilateral varicoceles. I no longer have pain, but both testicles continue to be lower than before the testicular pain began. I have researched studies that have analyzed effectivness of surgery and other treatment options for this condition. My question to you is, being a 22 y/o who would definitely like to have kids one day, can varicoceles cause impotence? Should I be considering invasive treatment options other than the conservative approach that the practioner has suggested? If I do have the varicoceles removed what is to say that the veins that have picked up the collateral circulation will not end up with a varicocle as well? Most importantly, let's get down to the root cause...why do varicocles happen? Is this a circulatory problem that is a clue to a greater problem in my body. This is truly concerning to me, and I appreciate any feedback.
 Dr. Safaa Mahmoud - Wed Aug 09, 2006 12:55 pm

User avatar Hello,

A varicocele is a dilatation of the veins within the scrotum

15-20% of the normal fertile males may have Varicoceles
while it may be found in 40% of infertile males
The mechanism by which varicocele induce infertility and (sperms are impaired)is not known but some researchers relate that to impaired testicular thermoregulation.

The causes of varicoceles are not known, but probably due to abnormal valves inside the veins that impair the normal blood flow.

Varicoceles are commonly seen on the left side than in the right due to different anatomic factors.

Important consideration regarding varicoceles in adolescents are:
- the varicocele is a progressive lesion
- early repair of the varicocele prevents the development of infertility.

Surgery is the primary form of treatment for varicoceles.However, not all varicoceles need surgical correction.
Indications for surgical correction include:
To alleviate significant testicular discomfort not responsive to symptomatic treatment.
Reducing testicular atrophy (with volume of <20 mL, length of <4 cm).
Fear the possible contribution to testicular damage and infertility.
Clinical picture and physical examination are essential to determine the proper management approach.

Follow up with your doctor is essential.
Best regards,

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