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Varicocele of the testis
This is a dilatation of the veins surrounding the spermatic cord. This happens mostly on the left side. The cause of side preference is due to the anatomical peculiarity of the body. The spermatic veins collect to form the vein of the testis (testicular vein). The testicular vein brings the blood to the vein of the kidney on the left side. It joins it in a vertical way. This results in a heavy column of blood. The testicular vein on the right side joins the great lower vein of the body (vena cava) in an acute angle. There is no heavy column of blood on the right side.

When we stand (erect position) for a long time, the blood stays for a long time in the vertical vein of the testis on the left side resulting in its widening and in increased pressure in the draining branches of the vein. This results in its widening as well. The resulting dilated (widen) veins is the varicocele. It appears and feels in late stages as a bag of worms inside the left side of scrotum. It appears more in the standing position rather than the lying one. One may notice it during taking a shower. It may lead to enlargement of the scrotum or pain.

It has three stages. The first stage is when it is noticed by the way. The second stage is when it is noticed during standing only. The third stage is when the dilated veins are present as a permanent finding. There are many techniques for operating varicocele. All of them are nearly the same.




Varicocele of the testis
Note that the veins of the left side are dilated in comparison
to those of the right one.
V vein
A aretery
N nerve
Vd vas deferens
E epidedymis
T testis
Vc varicocele veins



Who qualifies for the operation?

Varicocel which causes symptoms like pain, big scrotum or patients who suffer from infertility are subjects for the operation.

How does the operation work?

The operation is done in lying position. The preferred operation is to separate the veins as high as possible. They are best reached through an incision at the lower side part of the abdomen. The peritoneum is pushed to the centre of the body. The veins are clamped and separated between tow instruments and ligated. The wound is closed in layers.




Incision



Frequently asked questions?
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  1. Does varicocele have an effect of fertility?
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    This is controversy. The presence of much blood around the testis leads to increased temperature of the testis and the epidedymis which may affect the quality of the sperms. The scientific publications vary in this regard. There is not a 100% guarantee for the effect of the operation on the quality of sperms, yet, there are some documented results regarding the improvement of the sperm quality afterwards.
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  2. Does varicocele lead to cancer of the testis?
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    No.
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  3. Can I practice sports in spite of varicocele?
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    Yes, you can if it is an early stage. It is advisable to perform only mild sports until after the operation if you have a third stage varicocele. It is also advisable to wears a testicular corset to push the testis and veins upwards. This reduces the condition and alleviates pain.
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  4. Is there any effect of potency?
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    No, there is no.
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  5. What is the effect of temperature on the disease?
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    High temperature leads to more dilatation of the veins and worsens the condition.