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A varicocele is similar to a varicose vein, but it occurs only in men in the region of the testicles, usually above the left testicle. It is quite common, and occurs in over 10% of men, often appearing in adolescence or early adulthood. It is essentially an enlargement of one or more pampiniform plexus veins, which drain blood from the testes. Research suggests that development of these enlarged veins may be due to slightly abnormalities in the way the veins work.
There may be few symptoms of a varicocele except a notable enlargement or bump that is clearly an enlarged vein. If squeezed it is usually not tender and feels somewhat firm. However, it is possible for varicoceles to enlarge more. Sometimes they may also cause pain, especially when sitting for long periods of time or if a person spends a day doing heavy work or exerting himself.
A possible complication of this condition is that it may produce infertility in some men, and an examination of causes of infertility would include making sure that a man does not have a varicocele. Another potential complication of an untreated varicocele is testicular atrophy (shrinkage) of a testicle. These complications don’t always occur, and treatment of this condition may only be indicated when they do, or if the varicocele is very large and/or causing pain.
Several methods may be employed to remove a varicocele. These include a few different open surgical techniques, which are often the most common repair methods. Surgeons may work from an incision in the abdomen or below the groin while a patient is under anesthesia (often local or conscious sedation). The dilated veins are located and removed (ligated or cut). Open surgical techniques are often performed as outpatient surgery and tend to be very successful. Men who have these surgeries may need to spend a few weeks recovering before resuming normal activities and may not be able to do any heavy lifting for about 6 weeks.
Other methods to remove a varicocele can include those that employ laparoscopy, though this isn’t a common method in many countries. Another option is called varicocele embolization, which is relatively new, and may sometimes be dismissed as a poor option. This uses catheterization to block a vein so that the dilated veins disappear. Studies on this method suggest it can be extremely effective and it has the advantage of quick recovery time. Still, many doctors feel open surgery is the best option, but medical opinion on the most successful treatment is certainly subject to change.
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