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Varicocele Embolization Procedure in Mukundapur, Kolkata

Varicocele

Varicocele Embolization Procedure in Mukundapur

Varicocele, a common medical condition, refers to the abnormal enlargement and dilation of the complex network of the blood vessel plexus, a network of veins responsible for draining blood from the testicles. Often, the outcome is an intricate web of enlarged vessels. Varicoceles are categorized into three sizes: small, medium, and large. Even though some individuals with varicoceles may not experience any symptoms, these enlarged veins that resemble varicose veins can lead to discomfort, testicular atrophy, and reduced fertility, among other complications. Because they are the most frequently found cause of aberrant semen analysis, low sperm count, impaired sperm motility, and abnormal sperm morphology, varicoceles are clinically significant. 

Healthcare providers are required to be aware of varicoceles because they are a common concern for males, especially those in the reproductive age range. Given the prevalence of varicoceles and the fact that they typically go undiagnosed throughout life,‌ 80% of men who have them can conceive naturally with their partners. 

At the Andrology Department of Manipal Hospitals, Mukundapur, our specialists are well-equipped and adept at diagnosing and treating varicoceles. By conducting comprehensive evaluations and crafting personalised Varicocele treatment plans, our doctors ensure tailored care for both symptomatic relief and fertility concerns. 

FAQ's

In general, men do not exhibit any symptoms. A man can have a varicocele without realising it. If symptoms do arise, they usually manifest in hot temperatures, after intense physical activity, or after prolonged periods of standing or sitting. Symptoms include:

  • Dull pain in one or more testicles

  • The scrotum may feel heavy or as if something is pulling on it due to the veins appearing enlarged, often described as having an appearance similar to a bag of worms

  • Testicle soreness or smaller testicles on the side of the scrotum where the dilated veins are located (due to change in blood flow)

  • There is a small lump located above the impacted testicle

  • Decrease in testicular size (testicular atrophy)

A study of your symptoms, a physical examination, and your medical history are all part of the varicocele diagnosis procedure. Your doctor might examine your scrotum during the physical examination.

  • Standing and Lying Down: The patient is examined both while standing and lying down. Varicoceles are usually more prominent when the patient is standing due to gravity's effect on blood flow.

  • Palpation: The healthcare provider will palpate (feel) the scrotum to detect any enlarged veins. This is often done using the Valsalva maneuver, where the patient is asked to take a deep breath and bear down as if trying to exhale forcefully while keeping the mouth and nose closed. This increases abdominal pressure and makes the varicocele more noticeable.

  • Digital Imaging: The most popular test for diagnosing varicoceles is a scrotal ultrasound. This non-invasive imaging test uses sound waves to create images of the structures within the scrotum and can help visualise the dilated veins of a varicocele. It also helps in assessing the size of the veins and the blood flow through them.

  • Blood Tests: Sometimes, blood tests might be ordered to check hormone levels, including testosterone, to assess the impact of the varicocele on hormonal balance.

  • Semen Analysis: A semen analysis is often performed to assess sperm quality and determine whether a varicocele is influencing fertility.

Three surgical options could be considered.

  • Varicocelectomy: This open procedure is done while under a general or local anaesthetic. The groyne, or less often, the abdomen or upper thigh, will be the surgeon's point of entry. To divert the blood through healthy channels, they will seal the impacted veins using surgical microscopes and ultrasonography. The patient usually experiences little pain following surgery, and they can quickly resume their regular activities.

  • Laparoscopic Surgery:  A minimally invasive technique where small incisions are made, and a laparoscope (a thin tube with a camera) is used to view and treat the varicocele. Special instruments are used to ligate (tie off) the affected veins. Typically involves less recovery time and fewer complications compared to open surgery.

  • Percutaneous Embolisation: A radiologist uses the groyne or neck to introduce a catheter into the body. Once the instruments are inserted through the tube, the surgeon treats the vein with coils or chemicals. This procedure is deemed minimally invasive and has a relatively short recovery time, making it suitable for outpatient treatment

A varicocele is a swollen vein that occurs in the scrotum, the sac of skin that holds the testicles. This condition commonly develops on the left side during adolescence in many males. Neglecting to treat a varicocele can lead to a decrease in the quality and quantity of sperm, ultimately increasing the risk of infertility. 
 

Varicoceles can certainly affect one's fertility. Studies have revealed that varicoceles are responsible for about 40% of male infertility cases. However, many people with varicoceles do not experience any difficulties in achieving pregnancy.

Experts in medicine need to be made aware of the role varicoceles play in infertility. The buildup of blood in the veins likely leads to an increase in temperature within the scrotum. Both testicles' increased temperature may impact sperm production or count. If you suspect you are infertile, seek advice from a healthcare provider. The primary reason for addressing varicocele is due to problems with fertility. 
 

The recovery process following varicocele treatment varies depending on the method used, but generally involves a period of rest and gradual return to normal activities. Immediately after a Varicocelectomy, which is often an outpatient procedure, you may experience pain and swelling managed with prescribed pain relievers. You may also require rest and avoid strenuous activities for the first few days. Additionally, applying ice packs and keeping the surgical site clean is crucial. 

Within the first week, light activities can be resumed, and a follow-up appointment will ensure proper healing. By weeks two to four, you can gradually return to normal activities, avoiding heavy lifting until fully cleared by your doctor, with most patients resuming all activities within four to six weeks. For non-surgical treatments like embolization, the initial recovery involves a short observation period, mild pain management, and a few days of rest, followed by a gradual return to normal activities and a follow-up appointment. 

Throughout recovery, wearing supportive underwear, maintaining a healthy diet, staying hydrated, and avoiding sexual activity are important, along with being vigilant for signs of complications such as severe pain, infection, or changes in testicular size. Regular check-ups and, if applicable, periodic semen analysis for fertility monitoring are recommended for long-term care
 

In extreme situations, varicoceles can result in testicular atrophy, where the affected testicle shrinks. This happens because the testicle is not receiving enough blood flow, which can cause tissue damage and scarring. This can decrease testosterone production and harm fertility. 
 

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