VARICOCELE
Varicocele is the expansion of the testicular veins that prevalently manifest themselves to the left in order to follow their way down toward the left vein. Consequently, instead of being immersed in the general circulation, the blood from the veins returns from the testicles, reflowing and stagnating in the testicle proper. Appearing at puberty, and with numerous cases observed as here in Italy, it involves roughly 17-20% of the male population. Varicocele is recognised by a familiar component - heredity, that is to say, a condition of "weakness" of the valve present within the vein that can produce in the male not only varicocele, but also haemorrhoids and varicose veins in the legs, the very same pathology often present in brothers or parents.. |
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Varicocele brings about a slight growth in the testicle during puberty and/or a reduction of fertility in the adult. In fact, in the presence of varicocele, the temperature of the testicles rises above the [normal level] value, arriving at hormonal, adrenal vasoconstrictivity which reduces the oxygenation until finally causing a stagnation of toxic waste, which is supposed to go away but persists.
If occurring during puberty, the testicle carrying varicocele grows slower than the other or may become extremely voluminous. It is necessary to rapidly attend to medical examination.
After marriage, the presence of varicocele represents the most frequent cause of male infertility (20-25% of the cases).
At the semen examination, it is shown that there is a reduction of the motility of the spermatozoa, the modification of morphology... and finally a reduction in number of sperm.
The harm to fertility slowly grows more with time; at other times, it may entail a rather rapid course.
According to some studies, the presence of varicocele in the male, if it has nonetheless achieved pregnancy of the partner, increases the risk of premature abortion for a series of complex, biochemical factors, altering the "unwrapping" of the chromosomes from the head of the sperm. With varicocele, the Patient may complain, moreover, of recurring testicular pain, more obvious in the evening or after physical fatigue and sports activity.
The diagnosis is executed with a simply Andrological visit; a testicular Doppler or an ecography can confirm the pathology with great facility and precision, provided that it is done by an expert and the Patient is on his feet during the examination.
The therapy is evaluated case by case according to age, anatomical condition, seminal and hormonal data. It may be of a surgical kind, that is, a ligature (selective tying of the dilated veins or percutaneous sclerotisation; this latter procedure is also carried out in Day Hospital with local anaesthesia).At the pubescent age, surgical correction of varicocele enables normalisation of the testicle growth; in the adult, it brings about an improvement of various grades of the seminal fluid and a consequent augmentation of the probability of the partner becoming pregnant.
The best therapeutic results are obtained if the varicocele is cured as early as possible; therefore, it is important to undergo an early diagnosis.
