What is a varicocele? A varicocele is a swollen vein in the scrotum. Normal veins in the scrotums are usually constricted and not dilated. In varicocele, the veins in the scrotums are dilated. Varicoceles are more commonly found in the left scrotum than then in the right due to anatomic factors. Varicocele is a well-known cause of subnormal testicular function and can be found in approximately 20-25% of all males and in 40% of infertile males. As a matter of fact, varicocele is the leading cause of infertility in males. Varicoceles are easy to detect and can be easily corrected by surgical interventions.

Varicoceles are much more common in the left scrotum (80-90%) than in the right as a result of several anatomical factors. Also of importance is that right-sided varicoceles should be carefully investigated as more often than not, a right-sided varicocele may indicate cancer of the right kidney.

How do I know I'm affected by varicocele? A varicocele feels like a "bag of worms". Contrary to what most people believe, varicoceles usually do not cause any pain, but swelling of the scrotum, be it in one or both sides. Other problems that have to be excluded, that may cause scrotum enlargement include fluids in the scrotum, testicular cancer, a cyst or spermatocele, etc. In general, varicoceles are harmless, are not cancerous, although in the long run, they may give rise to infertility. Some health professionals believe that if left untreated, they may even cause cancer of the testicles.

What are the long term complications of untreated varicocle? If left untreated, varicoceles may give rise to several problems:

1. Testicular atrophy (or shrinkage)
2. Infertility
3. Testicular cancer (rare)

How is a varicocele diagnosed? Varicocele is diagnosed clinically by testicular examination. Alternatively, if a diagnosis of varicocele is uncertain, high-resolution color-flow Doppler ultrasonography is the diagnostic method of choice.

What are the treatment options available for varicoceles? Medical therapy has no place in the treatment of varicoceles. The main form of treatment for varicocle is surgery. However, the presence of a varicocele does not necessarily need surgical correction. Having said that, if treatment is indicated, surgical correction is the treatment of choice. There are several methods of surgical corrections, these include microscopic sub-inguinal varicocelectomy, inguinal varicocelectomy, retroperitoneal varicocelectomy and laparascopic varicocelectomy. In most cases, the patient is sedated.

What lifestyle changes can be carried out to optimize semen quality and quantity? There are ways for sufferes of varicoceles to improve their semen quality and quantity by life style changes, these include:

1. Quit smoking
2. Avoid use of marijuana
3. Avoid use of cocaine
4. Avoid use of anabolic steroids
5. Reduce alcohol intake
6. Avoid lubricants
7. Increase aerobic exercises.

Michael Russell

Your Independent guide to Infertility