Male pathologies: what is varicocele and how to treat it
Varicocele is the most common cause of male infertility and one of the most common diseases of the male reproductive system. It affects 1 out of every 9 men and is often ignored
What is varicocele
The varicocele is a pathology mainly linked to development, a period in which the testicles increase in volume and consequently also their vascularisation.
It is an abnormal swelling of the veins contained in the scrotal bursa (the skin sac containing the testicles) due to pathological reflux of blood, mainly to the left testicle.
This reflux causes an increase in temperature in the testicle, which in turn leads to oxidative stress with the release of substances that can damage cells, which seems to be responsible for a reduction in fertility.
A temperature slightly lower than the internal temperature is essential for the proper functioning of the testicles, which is why they are located in a sac outside the abdomen (scrotum).
However, if the temperature rises, as happens in the case of a varicocele, the production and quality of seminal fluid may decrease.
Symptoms for a diagnosis of varicocele
Varicocele is generally asymptomatic.
Sometimes it manifests itself with
- a sense of scrotal weight after exertion;
- palpable peritesticular swelling.
There may be several causes, but it is mainly due to insufficient competence of the venous valve systems, i.e:
- a congenital weakness of the vein walls;
- an incontinence of the valves, which over time can cause blood reflux.
Only rarely is a varicocele caused by vascular compression of a different nature, such as a retroperitoneal mass (in the area of the abdomen situated posterior to the peritoneum) or other vascular anomalies.
Varicocele and infertility: what is the link?
The correlation between varicocele and fertility has been debated for decades.
To date, however, varicocele is considered the most common, but correctable, cause of infertility in men.
However, it remains a controversial topic, as patients with varicoceles often do not experience infertility, and correction of the varicocele does not always correspond to an improvement in sperm quality.
The importance of early diagnosis
As already mentioned, the pathology normally manifests itself at the age of sexual maturity, between the ages of 11 and 16.
It is very important to recognise it early so as to avoid compromising fertility and the health of the testicle(s) concerned.
Diagnosis is made by
- a scrotal ultrasound, which allows the degree of varicocele to be assessed;
- a spermiogram, which is used to estimate the number and quantity of spermatozoa”.
As primary prevention is not possible, the only possible means of prevention today is an andrological examination at puberty.