Varicocele Symptoms, Management and Treatment Options
Dealing with varicoceles can be tough, especially if you don't know much about them. In this blog, we'll cover what varicoceles are, their symptoms, causes, and treatment options. You'll also find tips on easing discomfort and living well with varicoceles. If you or a loved one is affected, this blog will offer valuable insights and practical advice to help you manage.
What is a varicocele?
A varicocele is a cluster of enlarged veins in the scrotum, a condition affecting around 15% – 20% of males. It typically causes minor symptoms, but in some cases, it can lead to significant pain that disrupts daily activities.
Varicocele symptoms
It can be hard to know if you have a varicocele as often they don’t produce any symptoms. However, if you do experience symptoms they usually fall within one of the following categories:
- The appearance and feel of your scrotum
- Pain in the groin or scrotum due to your varicocele
- Broader issues like male infertility and low testosterone levels
Let’s start by discussing what you might notice concerning the look and feel of your scrotum.
Visibly swollen veins – Over time, a varicocele enlarges and becomes more noticeable. Typically, the veins become twisted looking similar to a ‘bag of worms’. You may also find the testicle with the varicocele swells (studies indicate that in 80-90% of males, this occurs in the left testicle).
A lump in your testicle - If you notice a lump in your testicle or scrotum you should always get your doctor to check it out. However, should the lump be a varicocele, it’s unlikely to cause any pain.
A dull or uncomfortable ache in the scrotum – This is due to the pooling of blood in the area.
Two other varicocele symptoms which occur in the testicles are more troublesome since they relate to sperm and testosterone production. Namely:
Infertility - Sperm is produced in the testicles, and the enlarged veins of a varicocele may raise the temperature around them, potentially impacting sperm production, movement, and function. This can lead to lower fertility, with varicoceles being a leading cause in 40% of male infertility cases.
Low testosterone – There is also some evidence that varicoceles can reduce the production of testosterone. Low testosterone levels can also lead to other issues such as:
- Difficulty achieving a firm erection
- Low libido
- Depression
- Fatigue or low-energy
- Lack of ambition
- Difficulty sleeping
- Trouble concentrating
- Reduced exercise tolerance
The main cause of varicoceles
Varicoceles are thought to develop due to faulty valves in the veins near the testicles, leading to blood backup and vein enlargement. This often happens during puberty, when the testicles require increased blood flow for growth. The impaired blood circulation raises testicular temperature, potentially hindering sperm production and harming sperm.
Managing varicoceles
Varicoceles, which affect the male reproductive system, are quite common. While many people with varicoceles experience no symptoms, some may suffer from pain, discomfort, or other complications. Treatment options are based on the severity of symptoms, potential effects on fertility, and the individual's health, and can be divided into two main types: conservative and surgical.
- Conservative
For varicoceles, non-invasive treatments involve lifestyle adjustments and medications, often suggested for those with mild symptoms or those not yet considering surgery.
Lifestyle changes:
To manage varicocele symptoms and minimize complications, lifestyle modifications are recommended:
- Opting for supportive underwear: Wearing supportive underwear can ease pressure on scrotal veins, relieving symptoms.
- Avoiding prolonged periods of standing or sitting: Extended periods of standing or sitting can worsen symptoms by increasing pressure on scrotal veins. Taking breaks to move around can provide relief.
- Maintaining physical activity: Regular exercise improves blood circulation and reduces inflammation, easing varicocele symptoms.
- Following a balanced diet: Eating healthily reduces inflammation and supports overall well-being, contributing to symptom relief.
Medication:
Another conservative approach for varicoceles involves medications, usually aimed at alleviating associated pain and discomfort. Commonly prescribed medications include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Drugs like ibuprofen or naproxen are effective in reducing pain and inflammation linked with varicoceles.
- Antidepressants: Medications such as amitriptyline or nortriptyline can assist in managing varicocele-related pain.
Although lifestyle adjustments and medications can provide relief from varicocele symptoms, they're typically not a permanent fix. Surgical intervention might be required for individuals with severe symptoms or fertility concerns.
- Surgery
Surgery aims to block the affected vein and redirect blood flow into healthier veins, facilitated by alternative circulatory systems supplying the scrotum.
Treatment outcomes may include:
- Eventual restoration of the affected testicle to its normal size. In adolescents, it may catch up in development.
- Enhancement of sperm counts and correction of sperm irregularities.
- Improved fertility or semen quality, that is beneficial for in vitro fertilization.
Surgery procedures include Microscopic varicocelectomy or Laparoscopic varicocelectomy, both of which can take several weeks for a full recovery.
Fortunately, there is an alternative for those who can’t have surgery or prefer not to do so.
Embolization
During this minimally invasive procedure, an interventional radiologist places a small tube into a vein in your groin or neck under local anesthesia and possibly a sedative for comfort. Using imaging guidance, coils or a scarring solution are released to block the affected vein, typically lasting about an hour. Recovery is swift, with mild discomfort, enabling a return to work in 1 to 2 days and exercise within a week. Consult your radiologist for guidance on resuming all activities. You can read about the benefits of embolization here.
Seeking medical help
If you're experiencing varicocele symptoms, it's vital to see a doctor for diagnosis and treatment advice, which could involve medications or surgery. Concerned about fertility? Your doctor can assess it and offer tailored recommendations. Despite challenges, with proper support and strategies, living well with varicoceles is achievable.
To summarize
Although varicoceles might not always produce symptoms or complications, seeking medical advice and considering treatment options can lessen potential risks and enhance overall health and fertility prospects. If you're experiencing symptoms or fertility concerns, don't hesitate to schedule a consultation with MINT Stl to discuss your diagnosis and treatment strategy.