Causes and symptoms of 1, 2, 3 and 4 degrees of varicocele
Definition of varicocele
A varicocele is a varicose vein that forms a plexus uviform (plexus) of the testicle. The word "varicocele" in translation from Greek means "tumor from the venous nodes." This pathology is quite common among all age groups, but it is more often diagnosed in adolescents from 14-15 years of age during puberty.
Varicocele is determined in 10-15% of men, if they are men with infertility, then varicocele manifests itself in 40% and in 80% of men with secondary infertility, that is, those from whom women have already had offspring.
Varicocele occurs as a result of increased pressure in the veins, usually due to the peculiarities of their anatomical location. Due to the peculiarities of the course of the left testicular vein, varicocele often occurs on the left. The factors contributing to the development of the disease include prolonged excessive physical activity, diseases that increase intra-abdominal pressure, thrombosis or constant compression of the veins of the kidneys.
Male infertility is based on three factors: inferiority of spermatozoa, a sharp decrease in their number, violation of their advancement and ejection outward. The occurrence of these problems can provoke varicocele, as a result of this pathology, the temperature rises in the testes, their functions are disrupted, which leads to damage to the sperm.
Varicocele, in other words, is a varicose veins of the spermatic cord and testicle, this disease develops when the valves in the veins malfunction, which contributes to the reverse blood flow.
In the initial stages, varicocele may be asymptomatic. Only pain in the scrotum and testicle, intensifying as the disease progresses, can state its appearance. As a rule, patients experience a pulling pain in one or both testicles, the scrotum, in the groin area, there is an increase or descent of the scrotum on the left side.
Pain sensations increase with physical exertion, walking and during intercourse. The disease is very dangerous for its consequences for men of reproductive age. Testicular varicocele disease can be chronic. Often, a deviation from the norm in many men turns out to be an accidental finding when examined for some other disease.
1, 2, 3, 4 degrees of varicocele
There are four degrees of varicocele:
- Grade 1 - varicose veins are determined only with the help of an ultrasound device or the Doppler method.
- 2 degree - the expansion of the vein is palpable in the standing position.
- Grade 3 - dilated veins are palpable in any standing or lying position.
- 4 degree - the expansion of the vein of the testicle and spermatic cord are visible on visual inspection.
Varicocele appears in adolescents of adolescence, during puberty, after reaching some degree, it no longer aggravates. It is extremely rare that a transition from one degree to another is possible. Varicocele on the right or on both sides is rare.
A change in the genital vein is detected by a urologist during a visual examination. If the increase in veins is insignificant, then a special examination is carried out for greater conviction.
During examination, varicose veins are detected by touch when straining in an upright position of the body, while visually it is visible whether there are changes in size and when probing it becomes clear whether the consistency of the testicle has changed or not. If in doubt about the correctness of the diagnosis, a routine ultrasound examination is performed to determine the size of the testicle and the internal structure.
An ultrasound scan using Doppler ultrasound is also prescribed, this method examines the testicular vessels and the nature of the blood flow in them, accurately reveals whether there is a reflux of blood back into the veins of the spermatic cord. Laboratory diagnostics are used - spermogram, to clarify the degree of dysfunction of the testicle, only the surgical method of treating varicocele gives a positive effect.
If the disease is manifested by pain in the scrotum or infertility, the operation must be performed as soon as possible after the diagnosis. If a man with varicocele is not worried about anything, and there is no need to continue the offspring, then you can do without surgery. There are three main treatments for varicocele:
- traditional surgery or Ivanissevich's operation - carried out by the method of ligation, intersection or removal of the varicose vein, incisions are made, about 3-5 cm long.endoscopic surgery - three small punctures are made in the patient's abdomen, an endoscope is inserted through one of them, the vein of the affected testicle is ligated … The operation takes about 15-20 minutes.
- sclerotherapy of the veins of the spermatic cord - a catheter is inserted through a puncture of the femoral vein into the groin, penetrates into the inferior vena cava, then into the left renal vein and further into the mouth of the affected vein. It is filled with a sclerosing substance, thereby stopping the flow of blood through the vessel.
The advantages of these types of surgery include the absence of blood loss, quick recovery. Recovery occurs after a month of rehabilitation period, it is recommended to exclude sexual intercourse, limit the use of salt, spicy and bitter foods, physical activity.
Among the possible unpleasant processes after the operation, varicocele is distinguished by stagnation of lymph in the tissues of the testicle, edema of the testicle and scrotum, pain in the testicle, and dropsy of the testicle. All this goes through time. The chosen method of operation is of great importance. For example, the laparoscopic or microsurgical method excludes violation of the integrity of the seminal artery and testicular atrophy, impaired reproductive function. Also, modern surgery guarantees the absence of relapses, re-emergence of testicular varicocele.
As a possible consequence, varicocele can cause endocrine infertility, which consists in impaired spermatogenesis and sperm morphology, and immune infertility, when the own immune system detects foreign tissue of the testicle and sperm and exposes them to attack.
Indications for surgery
Varicocele surgery only needs to be done in 3 cases:
- If the testicle has decreased in size
- If a person feels discomfort
- If sperm count has decreased
In all other cases, only observation by a urologist every six months is enough.
Prevention of varicocele
Prevention should be given due consideration at any age. Pathological varicose veins in children can be congenital and acquired, the diagnosis is mainly 1 degree. If a boy grows up in the family, it is necessary not to forget that such a problem may exist, since 10% of the examined patients have grade 2 disease, and grade 3 varicocele is observed in 5% of adolescents. In childhood, pathology can be eliminated with medication.
At the age of 19–20 years, every man should be examined by a urologist. Usually, by this time, puberty is completed and if varicocele is not detected, then the appearance of the disease is no longer threatened. A healthy lifestyle, good nutrition and rest, moderate physical activity, the use of vitamins are necessary conditions for the prevention of varicose veins of the spermatic cord and testicle.
Treatment without surgery
The accumulation of blood in the varicose veins negatively affects the supply of oxygen to the tissues of the testicle and epididymis. Stagnant blood in one area can lead to complications in another not prone to varicocele. The external sagging of the affected side of the scrotum does not look very attractive either.
We have not yet created methods and means of treating varicocele without surgery. It is impossible to eliminate this problem without a urologist, and even more so it is useless to look for recipes for traditional medicine, ointments and lotions will not give any result.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".