Urology Specialist Prof. Dr. Yavuz Önol Appointment Phone: 02122307644 https://onoluroloji.com/ What is Varicocele? The testicles are located in the loose and elastic testicular bag called the scrotum. The testicles begin to form in the waist area while in the womb and after the 7th month of pregnancy, they descend towards the groin and settle in the scrotum. Due to this process, the veins of the testicles come from the waist area. The testicle is suspended from the scrotum by a vascular stalk coming from the waist area. The abnormal expansion of the veins of this stalk is called Varicocele. Varicocele can even show itself to the naked eye with many folds like a worm on the surface of the scrotum. What Causes Varicocele? The exact cause of varicocele is not known. It is seen at a higher rate on the left side. The reason for this is shown as the venous (vein carrying dirty blood) blood flow on the left side opening more vertically upwards. In other words, blood flows into the main veins with difficulty, which leads to vein dilation (varicocele). Another reason is that the valve valves in the venous vessels are defective or incomplete. However, the exact cause is still unknown. Does varicocele cause infertility? Varicocele, which causes infertility, is tried to be explained by the toxic effect of dirty blood pooling in this enlarged vein and the increase in temperature in the testicle. The reason why it is less visible in the right testicle is that the flow here is easier. Varicocele can cause sperm disorders for these reasons. It can also disrupt the normal development of the testicle. The testicles can shrink. Varicocele Symptoms It is present in 20 out of every 100 men. Only 20 percent of this causes infertility. In other words, 4 percent of total varicocele causes infertility. Varicocele usually does not show any symptoms. In addition, there may be pain in both testicles. Varicocele is detected incidentally during the examination performed due to this pain. In fact, the cause of this pain is the stretching of the testicles due to the increase in sexual feelings during puberty. This pain goes away with masturbation. Varicocele surgery should not be performed immediately. Varicocele Diagnosis Varicocele diagnosis is very easy. Varicocele can be observed and diagnosed with a simple physical examination. Varicocele can be felt by hand. Most varicoceles do not cause any complaints. They rarely cause pain. Varicoceles only require surgery in 5-6 percent of cases. Unnecessary surgery should be avoided. When Should Varicocele Surgery Be Performed? Most varicoceles do not show any symptoms at all, but are diagnosed incidentally during the examination of the man in couples who apply to the doctor due to infertility. In addition, boys apply to the doctor for pain and swelling in the scrotum (testicular bag) during puberty. Testicular cancer can also be seen in the testicles during puberty. Testicular cancer has similar symptoms to varicocele. Therefore, an ultrasound should definitely be performed after a good examination. In this way, testicular cancer or varicocele can be diagnosed accurately. Varicoceles that are very advanced and start to shrink in the testicles should be operated on. Pain alone is not a valid reason for surgery. Severe pain in the testicles that occurs from time to time during adolescence should definitely be seen by a urologist, as it can be confused with testicular torsion, which we call testicular rotation. Testicular torsion, which we call the rotation of the testicle around its stalk, requires emergency surgery. Varicocele Surgery Surgery is required in patients whose infertility is understood to be due to varicocele and whose testicles are shrinking. With a small 2 cm skin incision made in the groin area, the enlarged veins in the inguinal canal are found with the help of a microscope or a loupe (magnifying glass). They are tied and closed. Thus, the blood is drained normally. The other veins in the testicle are sufficient for the drainage of the blood. Therefore, the cancellation of the enlarged vein does not affect the testicle. The patient is discharged on the same day. He returns to normal physical activity in 1-2 days. Improvement in sperm quality begins at the earliest in 4-6 months. Improvement in sperm quality continues increasingly for up to 2 years. This open Varicocele surgery is called the Micro Surgical Sup Inguinal approach. ​In other surgical methods, a similar procedure is performed by entering the abdomen from above, using the laparoscopic method (closed method). It is not preferred. It has not become popular. It causes more trauma to the patient. ​Another method is the Wig Embolization method performed by interventional radiologists. A solution that blocks the vein is given into the dilated vein. Or a stent is applied. It is a more laborious method for the patient. Open surgery, which is performed using a microscope and a loupe, is the most appropriate method for treatment. This surgery is called microsurgical varicocele surgery. Our video, in which we answer your questions such as what is varicocele, how does varicocele pain occur, what are the symptoms of varicocele, after varicocele surgery, and provide information about left testicular pain, increasing sperm quality, varicocele treatment, and herbal solutions for varicocele, is on air. We wish you a good time.