Male infertility and varicocele also known as pampiniform plexus has been a painful factor for men and majority of men undergoes different battles when diagnose with varicocele disorder. Previously varicocele have been causing serious disappointment for men at their ability to enjoy fatherhood, while other men went through terrible disturbing pains, discomfort and unable to enjoy sexual fulfillment.

WHAT IS VARICOCELE

Varicocele is an unusual enlargement of veins within scrotum (loose skin holding testicles, veins, and arteries) also known as varicocele testicle, and layman call it different name such as varicocel, varicoceli, varicocoele, varicocoele, vericocele, varicoceles or varicosil. Normally, these veins supply blood to reproductive glands. In case of any abnormality like varicocele, blood blockage comes about and damages male fertility and might also affect men’s erection or testosterone level.

It is more obvious in standing posture and vice versa. In layman terms Varicocele is a varicose vein in the scrotum just like varicose vein in the legs. The causes of improper functionality of varicose veins in legs and in testicles are similar. The significance of this disorder is greater due to the fact that it is the most common reason for infertility related problems in men. It lowers the sperm count of a man and also undermines its quality. However, if varicocele is detected in your one testicle, it affects sperm production of both testicles, sometimes testicles shrink as a result of this.

Usually, it attacks mostly on the left side as 85% it occurs on the left scrotum and remaining 15% tends to occur on both sides simultaneously. The incidences that involve occurrence only on the right side are few and far between. There are 3 primary reasons of this predominant left side occurrence:

• The angle at which the left testicular vein enters the left renal vein.
• No effective anti-reflux mechanism between testicular vein and renal vein.
• Increased renal vein pressure as it lies between the superior mesenteric artery and the aorta. This phenomenon is also referred to as “nutcracker effect”.

Prevalence percentage of Varicocele among men is alarming. Up to 15% to 20 % of all men tends to have Varicocele at some stage in their lives. Unfortunately, it is most likely to prevail in early adulthood, between the ages of 15 to 30 years and is mostly left unnoticed, under-diagnosed and untreated.

Some believe that the risks of it may be limited with age but it is highly unlikely due to overall physical degradation of man with aging that leaves its body vulnerable to varicocele. Small varicocele which can only be identified by bearing down and can go undetected for decades. Men in their 40’s or sometimes even in their early 50’s come with this type of varicocele.

CAUSES

It is not a sudden condition; it develops with time. Usually the blood tends to flow in the wrong direction in testicular vein known as reflux. Reflux then causes swelling and widening of the veins. This mechanism is responsible for Varicocele and a strange feeling of fullness (like a loose bag hanging) can be noted around testicles.

Improper Functioning of Veins: If valves within veins do not function properly, it will cause blood blockage

Anatomic Asymmetries: Varicocele may also result from anatomic changes between right and left inside spermatic veins. As left internal vein is longer than right vein, it needs extra pressure to circulate blood through the left vein.Sooner or later, it leads to varicoceles.

The Nutcracker Effect: It also results from compression of renal vein that is close to left kidney. This compression results in blood blockage in left spermatic internal vein. When it tries to regulate the flow of blood to heart through renal vein, it causes varicocele.

Spermatic cord performs blood circulation activity to and fro your testicles. As a matter of fact, there is uncertainty about the causes of varicoceles; however, experts believe when valves inside your veins in spermatic cord stop blood from proper flowing, it widens veins. Varicoceles form during sexual maturity.

The blood tends to flow in the wrong direction in testicular vein known as reflux. Reflux then causes swelling and widening of the veins. This mechanism is responsible for Varicocele and a strange feeling of fullness (like a loose bag hanging) can be noted around testicles.

TYPES

Varicocele is divided into 3 clinical grades depending upon the lump size in testicles and visibility. These are labeled as Grade I to III. Grade 1 is the smallest, Grade 2 is medium size whereas Grade 3 is the largest lump size.

1. Small – Identified only by bearing down, which increases intra-abdominal pressure, thus impeding drainage and increasing varicocele size. This process of identifying varicocele is called Valsalva maneuver.
2. Medium or moderate – Identified by palpation without bearing down (Valsalva maneuver).
3. Large – Easily identified by visual inspection alone.

SYMPTOMS

Patient may not experience any symptoms in the beginning; however, given below likely symptoms can help you identify it:

• Swelling in the scrotum or lump in the testicles
• Twisted or enlarged veins within scrotum
• Sharp or dull pain in the testicles
• Scrotal heaviness
• Dragging sensation
• Bulge in the scrotum,
• Testicle Lump (mostly painless),
• There might be no apparent symptoms at all

Physical condition gets worse when patient physically exerts himself sitting or standing. Prolonged exertion periods increase chances of painful conditions. Mostly varicocele grows and patient becomes aware of his condition.