Let us go to the
basics
What is a VARICOCELE?
Varicocele is a piles like
condition (as in the anus) affecting the veins in the
scrotum(testes)
How common is
it?
Almost
11 % of healthy normal males are found to have varying grades of
Varicocele.
Does it Affect
everyone?
NO! Only a small percent of this large number of cases will be
affected in terms of Fertility
How & What are the
effects of the Varicocele
What IS NORMAL?
Sperm production in the
testes requires a constant cool temperature within and surrounding the testes.
This is acheived in the normal healthy male by a constant inflow of arterial
blood and outflow of venous blood without any hold up. This results in a local
'Air Conditioning' effect in the testes.
How am I DIFFERENT?
In a patient with the
varicocele, there is a near normal inflow of the arterial blood but the venous
outflow is hampered resulting in venous congestion and back pressure towards the
testes. This is beleived to be due to lack of (valves) pumping action in these
veins.
How does it show
up?
As a
result, when the person is upright, the venous blood instead of climbing up from
the scrotum, pools in the region of scrotum, resulting in a 'bunch of
worms' appearance in the scrotum; typically the patient cmplains of
dragging pain in the scrotum, going on to the groin and even to the low back on
the same side (Note that this condition is commoner on the left side than the
right - this is due to the anatomical variation associated with the way this
vein joins the main blood circulation). The congestion increases venous pressure
(and may hamper the arterial inflow)in the fine tubes in which the sperms are
formed and results in poor quality and quantity of sperm
production.
What do I do
Now?
Consult your Urologist ....Dr Iyer of course! You will undergo a
physical examination erect & lying down with special attention to your
genital area. This will be followed by an advice for Semen Examination
& a special scan on your scrotum called DOPPLER SCAN. If found necessary,
the doctor will also advise you to undergo a Hormone profile(blood
test).
What
Next?
After
review of the above tests, if the Doppler scan is positive, the Doctor will
advise a Surgery.
Surgery........?
This involves a small cut in
the groin region to expose the congested veins which are isolted and clipped
after isolating and preserving the important structures - the artery to the
testes & vas, the vas deferencs -the semen transporting tube and other tubes
called the lymphatics. Usually this surgery requires use of microscope or
magnification and is called Microsurgical operation. IT usually involves one (or
two)day's stay in the hospital and may require 2-3 days' off work.
How effective is
it?
Surgery
if done for the correct indication and with proper technique has a 60-70%
chances of improvement in the semen parameters. These changes may take as long
as 12-18 months to show up and may require persistence on the part of the doctor
and patience on your part. It is quite likely that the doctor will put you on an
extensive coursse of medications to stimulate the semen production. in case the
hormone profile shows a deficiency, you may require a cyclic hormone
therapy.
And... the Side
Effects?
Hydrocele of fluid collection around the testes - quite common
unless an add on procedure is done to avoid this sequel; a complete surgery
includes a total clearance of the additional veins, a testicular biopsy and a
hydrocele prevention procedure. As the groin contains many sensory nerves,
surgery in this area may leave a numb area and in some it may leave a senitive
scar. None of these last 2 side effects are predictable or
preventable
Finally..... GOOD LUCK WITH YOUR SURGERY and Hope you become a
FATHER SOOOOON!
