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Pain-in-the-Scrotal-Region-as-a-Result-of-Varicocele

Varicoceles refer to varicose veins that occasionally appear on the scrotum.

Varicoceles function similar to varicose veins that appear on legs, but they're rarely harmful and never life-threatening.

  • Approximately one in six men deal with varicoceles over the course of their life
  • They most commonly appear in younger males between the ages of 15 and 25.

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Are There Symptoms?

Despite the fact that varicoceles are largely harmless and fairly common, they serve as a disproportionate contributing factor for infertility in men. Men evaluated for infertility display a varicocele in at least one testicle 40% of the time. While varicoceles normally develop over an extended period of time, they're easy to detect and eminently treatable, even in advanced stages. A cursory examination by a qualified physician can usually identify the presence of a varicocele in a patient. But since varicoceles are generally innocuous and often don't result in symptoms, they may go undetected for an extended period of time.

When symptoms do occur, they typically manifest as a dull or sharp discomfort within the scrotal region. Pain may increase in intensity over the course of the day, and it may also be exacerbated by standing or physically exerting oneself, particularly over an extended period of time.

Ultrasound-Diagnosis-of-Varicocele
Varicoclectomy-Procedure

Diagnosing Varicoceles

Diagnosis for most varicoceles is a simple process that can be achieved through a routine physical exam. The doctor will feel the testicles of the patient as they stand. Prominent varicoceles can be seen by the naked eye, and affected testicles are often of noticeably reduced size. Less prominent varicoceles may require further scrutiny to identify. This may necessitate Doppler ultrasonography or thermography, but these processes are painless and easy to perform. Advanced procedures are usually only necessary when patients exhibit recurring or chronic pain or when infertility is a demonstrated issue.

Causes

The root cause of varicoceles has yet to be determined, but it's widely believed to be the result of defective valves within the veins of the scrotum. The dilation of veins is thus caused due to limited blood flow. Faulty valves cause the blood to back up, manifesting through engorged veins. This also results in a higher temperature in affected areas, a main reason why thermography can be an effective means for identifying problems. This higher temperature is also the root cause of infertility resulting from varicoceles.

Treating Varicoceles

The most common treatment of varicoceles is microsurgical varicocelectomy. To achieve higher success rates and lower risks, varicoclectomies are performed using high-powered operating microscopes. These allow the precision doctors need to target the specific vein for treatment. The inguinal approach is most often used when patients are suffering pain as a result of a varicocele. The vein causing the problem is dissected circumferentially at which point it's tied off to disrupt the flow of blood and allow for proper drainage away from the testes. The subinguinal approach happens lower in the groin and is more commonly used in cases where infertility is the primary issue. The procedure typically takes a half hour to perform, and recovery times usually last between two and three weeks

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faculty_gelman
Joel Gelman, M.D.
Male Urology
HS Clinical Professor-VCF
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Faysal A. Yafi, M.D., F.R.C.S.C.
Male Urology
HS Assistant Clinical Professor, Medical Director Men’s Health Program

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