Varicocele
What is Varicocele?
Any swelling or lump in the scrotum must be taken seriously as testicular cancer is the commonest malignancy in younger men. Fortunately the vast majority of swellings turn out to be nothing serious, simple cysts of the epididymis being the commonest finding. Inflammation or infection in the epididymis or tubes around the testicle is also relatively common. This is epididymitis which can be treated with antibiotics. An ultrasound scan can provide reassurance that there is no serious problem.
Another common benign (non-cancerous) swelling is a varicocele which is essentially varicose veins affecting the testicular veins, usually on the left side. An ultrasound scan can assess the diameters of the veins and more improtantly the blood flow and any evidence of reflux or reverse flow in the veins. A common underlying problem is incompetence of valves higher up in the veins where they run up towards the kidney. This allows blood to reflux and pool down into the scrotal veins instead of flowing back up towards the kidney, leading to distension, swelling and discomfort.
What are the symptoms of Varocele?
A varicocele may present as a swelling (sometimes described as a ‘bag of worms’) or dull aching discomfort that may be worse on standing for long periods, on straining or during sporting activities. Varicoceles are graded on a scale of 1-4 in terms of severity and the majority of varicoceles are left sided due to different drainage of the veins from the testicle on the right and left. Dr. Crowe would normally see you for an initial ultrasound and the findings are discussed with you at the time of the scan.
There is a higher incidence of varicocele in men with subfertility and although not a serious medical problem varicoceles can be associated with a reduced sperm count and quality. There are several theories as to why there is an association of varicocele and fertility problems including the heating effect of the distended veins on the testicle impacting on sperm production.
Varicocele Embolisation for Male Infertility
Infertility is frequently a multifactorial problem with contributory factors from both the female and male partners. Similarly there may be multiple contributory factors to male infertility resulting in either a low sperm count or in poor quality sperm with reduced motility or abnormal sperm forms. Dr. Crowe works with specialist urologists and fertility specialists in the investigation and treatment of male infertility.
