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What is it, whether surgery and treatment are needed without it, as well as a photo of the disease

Male genital diseases can occur at any age.

The problem is that most of them develop asymptomatically and lead to serious complications.

Among such ailments, varicocele appears most often.

What is a varicocele?

This disease was first diagnosed in the 16th century. After that, the doctors tried to find out the causes and consequences of varicocele, conducting a large number of studies. At one time it was believed that the disease is only a symptom of infertility. But then the doctors dispelled this myth, having discovered that this ailment is one of the forms of varicose veins that affects the male genital organs.

Violation of blood circulation leads to the fact that one of the testicles begins to show veins. The most common varicocele on the left is 1 degree, but there are cases of bilateral varicocele.

The disease affects heat transfer, which is why the temperature of the affected testicle rises significantly. This leads to impaired sperm production.

The first stage of the disease is the easiest, since it does not bring a man any particular discomfort.

In the second stage, the veins on the scrotum increase, and the patient often feels pain in the groin.

The third degree allows you to diagnose diseases without special methods.

If varicocele is not started to be treated in the first stages, then over time it will go into a more severe form.

Varicocele is the expansion of the veins of the spermatic cord. Specifically, the cluster of the venous plexus of the spermatic cord.

Varicocele is a common disease. According to various sources, varicocele is found in 15-35% of mature men.

The main cause of varicocele is congenital underdevelopment of the connective tissue valve apparatus of the veins. Therefore, in half the cases, varicocele is combined with other venous diseases: varicose veins, hemorrhoids, as well as genetic connective tissue abnormalities: congenital heart disease, phimosis, etc.

The second most important cause of varicocele is a kidney tumor that grows into the vascular plexus.

Typical symptoms of varicocele: discomfort and a feeling of heaviness in the scrotum, pulling, bursting pains, tortuosity and enlargement of the veins in the scrotum area are noticeable during examination, a decrease in the size of the testicle and softening of the testicle, irregularities in the analysis of sperm (spermogram).

Varicocele is diagnosed by a family doctor, pediatrician, urologist, pediatric urologist, surgeon, pediatric surgeon. In most cases, examination and palpation of the scrotum is enough, a test with straining (Valsalva test) is enough.

At the initial stages of the disease, ultrasound of the spermatic cord veins is used, including with a Valsalva test. In some cases, to determine the tactics of treatment, an X-ray contrast study is performed: phlebography.

Varicocele treatment is an operation performed under general or local anesthesia. Surgical intervention is reduced to dressing and embolization of the dilated veins, as well as to raising the testicle.

The most popular procedure is ligation of dilated veins. In recent decades, they have been using the Marmar microsurgical technique more often - in the area of ​​the inguinal canal, a small (up to 2 cm) incision of the skin and underlying tissues is performed, through which the dilated veins of the spermatic cord are ligated.

The recurrence rate does not exceed 3%.

Without treatment, varicocele is complicated by softening, “drying out” (hypotrophy) of the testicle and, as a result, male infertility.

As you know, the liquid can hardly be compressed, so the pressure generated by the reverse blood flow begins to be transmitted in all directions. After some time, as a result of high pressure, the veins begin to stretch and increase in size.

The strength of their walls can be different, and depending on the strength of the venous pressure, stretching reaches various degrees. The network of veins surrounding the testicle begins to increase significantly, which is why it seems to be immersed in a sponge from the vessels.

The scrotum is constantly overheating, and testicle cooling stops. In order for sperm to develop normally, a lower temperature is needed, which is no longer present.

Therefore, varicocele is considered the main factor in infertility in men.

What is a varicocele of 1 degree?

This disease was first diagnosed in the 16th century. After that, the doctors tried to find out the causes and consequences of varicocele, conducting a large number of studies. At one time it was believed that the disease is only a symptom of infertility. But then the doctors dispelled this myth, having discovered that this ailment is one of the forms of varicose veins that affects the male genital organs.

Violation of blood circulation leads to the fact that one of the testicles begins to show veins. The most common varicocele on the left is 1 degree, but there are cases of bilateral varicocele.

The first stage of the disease is the easiest, since it does not bring a man any particular discomfort.

In the second stage, the veins on the scrotum increase, and the patient often feels pain in the groin.

The third degree allows you to diagnose diseases without special methods.

If varicocele is not started to be treated in the first stages, then over time it will go into a more severe form.

Varicocele in men: features of the first degree of the disease

Varicocele is a type of varicose veins. It concerns the problem of male genital organs. Most affected are adolescents and men under 40 years old.

The disease is divided into the following forms:

  • left-sided
  • right-sided
  • bilateral.

With 90% probability, children develop varicocele on the left and then stop at 1-2 degrees. The course of the disease is aggravated by the influence of irritants. The bilateral form is manifested in every second patient older than 17 years. The right-hand variety accounts for no more than 2%.

The causes of varicocele 1 degree

Usually pathology affects men aged 15-30 years. The reason for its occurrence is the weakness of the human vascular system. Often, patients with varicocele are susceptible to varicose veins of the lower extremities, hemorrhoids, pathology of heart valves and other diseases of a similar etiology. The main reason is a hereditary predisposition.

An additional condition is the anatomical structure of the male body, directly that the left vein of the testicle flows into the renal vein at a right angle. This causes an increase in intravenous pressure, and explains the prevalence (over 80%) of left-sided varicocele among men.

Ancillary causes are health difficulties that provide an increase in intra-abdominal pressure and provoke thrombus formation or compression of the renal veins. For example, swelling of a kidney in a person of mature age can provoke a sharp expansion of the veins of the spermatic cord.

The course of the disease involves the stages:

  1. Varicocele of the first degree is called zero or hidden. There are no visual manifestations of the disease, with palpation, visible changes are also not observed. A disease of this stage proceeds asymptomatically, sometimes pulling sensations are noted in the testicle and spermatic cord. The weak course of the disease causes its late detection.
  2. The second degree of the disease is also almost not felt, but manifests itself only after a long stay of the patient in a standing position or physical activity.
  3. The third stage is accompanied by pronounced symptoms, such as discomfort when walking, during intercourse.
  4. The fourth degree of the disease is manifested by a significant decrease in testicular volume, a change in tissue density.

Symptoms and therapy of each stage of the disease are different. The first two degrees of varicocele in men are extremely rare, for this reason, to prevent the development of pathology, you need to consult a doctor.

Varicocele 1 degree in adolescents and men

The disease causes varicose veins, forming a cluster-like, rod-shaped, plexus of the left testicle. As a result, the spermatic cord is affected. There are four degrees of varicocele:

  • 1 degree - the pathology of the vein is not visually observed, it is determined only by ultrasound or by Doppler ultrasound,
  • 2 degree - in a standing position, the affected veins are palpated,
  • Grade 3 - affected veins can be felt in any position of the patient,
  • Grade 4 - the affected and deformed veins of the spermatic cord and testis are visible.

Most often, pathology is detected in adolescents from 14 years old and men aged 20 to 30 years. Experts believe that the disease, developing during puberty, reaches a certain level and further, as a rule, does not develop. The most common varicocele of 1 degree.

Features of the disease

In total, varicocele is divided into three stages. There is zero, when the pathology is detected by chance when examined by ultrasound.

In the first degree, dilated vessels can be detected by palpation, but only if the man is standing. With the progression of pathology, diagnosis is carried out without the use of complex mechanisms or devices.

The disease can proceed in different ways. Some men live with him for decades, have children, do not experience discomfort. In rare cases, you can expect that by 40 years the illness itself will pass. But varicocele of the first degree does not occur in all the same.

Sometimes pathology becomes a prerequisite for the development of atrophic processes, as a result of sclerotic changes and ischemia. The result of the lack of treatment is a violation of spermatogenesis, the development of male infertility.

Etiology and pathogenesis

If you look at the medical publications describing varicocele in men, you can see that the disease usually affects the left side of the scrotum. This is due to the anatomical features of the structure of the venous system of the testicles, the left testicular vein at a right angle flows into the renal.

Infertility with varicocele is due to the fact that the temperature in the scrotum rises significantly due to improper blood flow, which causes constant overheating of the sex glands and sperm. As a result of constant heating, sperm lose their motor activity, and the probability of fertilization of the egg is significantly reduced.

Varicocele affects men of different age groups, only about 18% of all representatives of the stronger sex of reproductive age. The disease is most often diagnosed at school age at the first mandatory examination by a urologist.

What are the causes?

Varicocele has several causes, including:

  1. Genetic predisposition. Often this applies to weak vessels, because of which circulatory functions are impaired.
  2. Pressure on the veins of the pelvis. The testicular vein is pinched by others, which leads to the development of the disease.
  3. Tumors of the pelvic organs.

Development mechanism

With varicocele, the veins of the spermatic cord expand. By the type of manifestation, the disease is divided into primary and secondary form. The first variety is considered independent or idiopathic (indefinite), and the second is a consequence of the impact of other pathologies. The disease is characterized by the following development mechanism:

  • there is a malfunction of the venous valves,
  • blood stops circulating fully,
  • a stagnant process develops
  • increased pressure on the veins, which leads to the development of pathology.

In healthy men, arterial blood flows freely into the testicles, becomes venous, and circulates further.

Symptoms of the disease

The primary degree of varicocele is subclinical. There are no vivid symptoms, the symptoms of the disease are:

  • discomfort in the scrotum,
  • groin discomfort,
  • soreness of the lumbar spine, frequent urination.

Symptoms are distinguished by their softening in a lying position, amplification during walking or when standing. Pathology is detected only by ultrasound, dopplerography.

Symptoms and manifestations of the disease at this stage

Varicocele of the 1st degree has virtually no symptoms, so it is often diagnosed by chance. Sometimes men notice an increase in the scrotum. To the touch you can feel the veins appear and harden. If these signs appear, you must immediately consult a doctor.

What is the difficulty of diagnosing the disease in the initial stages?

Every man should know which doctor he needs to contact if they detect signs of varicocele. First of all, this is a urologist, that is, a specialist who treats exclusively male ailments. In addition to the urologist, you can turn to the andrologist.

The methods that the doctor uses for diagnosis are quite diverse.

Swollen veins can be determined by touch, and ultrasound is used to clarify the diagnosis. Ultrasound can detect the size of the testicle, the nature of blood flow, the formation of nodes. Methods such as dopplerography and spermography are also used.

Causes of Varicocele

The main reason is congenital underdevelopment (dysplasia) of the venous system, more precisely, the valve apparatus of the veins. That is why in 65% of patients varicocele is combined with other venous diseases: varicose veins, hemorrhoids, etc.

Such a varicocele is called primary, or idiopathic. Violation of the function of the valve apparatus of the veins of the spermatic cord leads to stagnation of blood in the veins and, as a result, to the expansion of the veins.

Overflow of veins is facilitated by straining the child with crying, coughing, constipation, etc.

In 70% of cases, the veins of the left testicle are affected due to the fact that the vein of the left spermatic cord flows into the inferior vena cava at a right angle, which makes it difficult for blood to drain.

With a tumor in the right kidney that has spread to the vascular bundle, a secondary (symptomatic) varicocele develops.

Provocative factors

Despite the level of modern medicine, doctors cannot pinpoint the reasons for the development of varicocele. There are only approximate lists of irritants that provoke the expansion of veins. Predisposing factors are divided into 4 groups:

Provocative factors
Mechanical• Crushing of spermatic cord:
- hernia
- a tumor,
- the rectum.
• Violation of blood flow amid high intra-abdominal pressure. It is relevant for diarrhea or constant tension of the abdominal muscles.
• Violation of the function of the muscle that lifts the testicle (cremaster).
• Passion for horse riding or cycling.
• Continuous standing.
• Injuries to the inguinal region.
• Malfunctions in the blood flow caused by a vein compression in the left kidney:
- the aorta (bottom) and the superior branch of the mesenteric artery (top),
- an additional trunk of the renal vein.
Anatomical• Disruption in blood supply due to an excessively long vein of the left testicle.
• Violation of the function of the valves of the testicular vein.
• Left-sided connection of the veins of the testis and kidney at an angle of 90 °.
Genetic• Phimosis.
• Flat feet.
• Weak vascular walls.
• Varicose veins in the legs.
• Heart defects.
• Dysplasia of connective tissue.
Other• Long masturbation.
• Failures in the autonomic nervous system.
• Sexually transmitted diseases.
• Pathologies and conditions accompanied by a decrease in testosterone production.

Each of the stimuli to a certain extent contributes to the development of venous stagnation. For an early diagnosis and detection of a causative factor, a comprehensive examination will be required.

How to distinguish stage 1 from stage 2 varicocele

The second degree of the disease is determined by palpation of the dilated veins in the patient in a standing position and lying down. The reason for the development of this stage can be excessive exercise.

A pathology is felt without the need for a Valsalva test. The spermogram shows reduced sperm activity.

The absence of the necessary therapy leads to the transition of the disease into a chronic form and creates a risk for infertility.

Symptoms of the disease

With an ailment of the first degree, the symptoms are expressed in a significant expansion of the veins in the spermatic cord. This happens so much that the veins begin to be felt through the skin of the organ. At the initial stage, asymmetry may appear, which is caused by a pathological change in the left testicle.

Pain can become noticeable after sufficient physical effort. Especially often they are felt in the hip and pelvis. Discomfort can occur during intercourse. When the disease begins to progress, then pain in the lower back and frequent urination may appear.

Symptoms and classification of varicocele

In half of the patients, varicocele is asymptomatic: the swelling of the veins of the spermatic cord appears only when straining or palpating.

The disease is divided into 3 stages:

    • Stage 1 - dilated veins are not visible, palpable when the patient is strained (Valsalva test),
    • Stage 2 - dilated veins are not visible, but are felt without a Valsalva sample. Symptoms are absent or manifest as discomfort and a feeling of heaviness in the scrotum,
    • Stage 3 - dilated veins are clearly visible (protrude through the skin) and are easily palpated without a Valsalva test. Patients complain of drawing and bursting pain in the scrotum. Due to prolonged stagnation of blood, hypoxia and testis ischemia are formed on the affected side. As a result, the testicle decreases in size and softens, acquires a test-like consistency. Testicular hypotrophy is accompanied by pathological changes in the analysis of sperm - spermogram.

In world clinical practice, there are many classifications of varicocele for various reasons, the most convenient is the classification of N. A. Lopatkin, proposed back in 1978, but still popular with medical practitioners. According to this classification, the disease is divided into three degrees depending on the severity of its symptoms

  • I degree - varicose veins can be determined only by palpation with a certain position of the patient: he should strain in a standing position.
  • II degree - at this stage, the affected veins are already determined visually, but at the same time, the testicles retain their size and consistency.
  • III degree - the testicles are reduced in size, while the enlargement of the sphenoid plexus of the veins is very pronounced.

The classification of stages of varicocele adopted by the World Health Organization largely coincides with this classification.

Indications for surgery

The need for surgery is determined by a specialist. When the patient is concerned about childbearing, it is important to take into account that only surgery serves as a real way to restore reproductive health to a person affected by varicocele.

The essence of the intervention is to prevent the return of blood from the channel of the affected veins in the pterygoid plexus. Modern medicine has many therapies for varicocele.

Indications for surgery are provided:

  • impaired reproductive function due to the development of varicocele,
  • regular pain and discomfort in the groin,
  • testicular size reduction,
  • human ejaculate changes
  • the harmful effects of the disease on the mental health of the patient.

Other cases are bypassed by a specialist urologist every 6 months.

Conditions for the transition to the second stage

Varicocele can remain at a certain stage of development for decades. It is enough for the patient to be observed by a doctor and avoid exposure to irritating factors. As a guide, specialists have compiled a list of reasons that contribute to the transition of the disease from one stage to another:

  • prolonged course of diseases
  • constant stay in stressful situations,
  • infection in the body,
  • frequent rest in saunas and baths,
  • hot bath abuse
  • the appearance of excess weight
  • the development of inflammatory diseases,
  • permanent physical overload.

Treatment without surgery

Medicine has not yet found non-surgical methods of treating varicocele with the necessary level of effectiveness. However, at the 1st degree of the disease, the doctor may recommend the following as conservative methods of treatment:

  • Taking vasoconstrictor drugs,
  • Regulation of sexual activity,
  • Complete refusal of alcohol,
  • Swimming,
  • Physiotherapy (with an emphasis on tonic methods),
  • Prevention of constipation, flatulence, as well as the fight against other factors affecting the increase in intra-abdominal pressure (if any),
  • Wearing a suspension (special tight panties or swimming trunks),
  • Pouring perineum with cold water (the method is really effective only in the case of regular practice).

The causes of the disease

For a long time studying the causes of the development of this disease, modern scientists in the field of urology and andrology have not yet come to a consensus on the causes of varicocele.

It is believed that the development of the process in the left testicular vein is most often caused by congenital anatomical defects in the structure of the vessels that feed the blood and divert it from the testicle. Such a disease is called primary, or idiopathic, varicocele. Here, the structural features of the renal and testicular vessels on the left, underdevelopment or absence of vein valves, weak muscle fibers in the walls of the vessels play their role.

In the secondary process, which is most common in adults, the causes are tumor processes in the kidneys, retroperitoneal space, and small pelvis.

On the right, the process is extremely rare and almost always indicates the presence of a neoplasm.

As a result, blood pressure rises in the veins that drain blood from the scrotum, especially when standing. The venous stratiform plexus around the testicle increases, blood supply and sperm production are disrupted, which is further aggravated by an increase of 2-3 ° C in the local temperature of the tissues.


Varicocele stage 1 is investigated by various instrumental methods. Before their appointment, the doctor conducts a survey to identify:

  • Perineal injuries and infectious diseases
  • Chronic intoxication,
  • Overheating or hypothermia.

Since other problems can lead to an ailment, the presence of inguinal hernias and tumors in the history is clarified.

The urologist asks the patient to hold his breath. The patient exhales and begins to push, without overstraining. At this time, the veins become noticeable, easily palpated. Among diagnostic measures, an ultrasound study is often prescribed. The method relates to one of the most effective.

If necessary, an ultrasound scan is performed using a Doppler device. It allows you to examine blood vessels, determine the presence of reverse reflux of venous blood.

Additionally, other studies can be used to differentiate the diagnosis. These include:

  1. Phlebography. Used when other techniques do not give a clear picture.
  2. Radioisotropic studies.Aimed at studying the condition of the kidneys, testicles.
  3. Hormonal clinical studies. Needed to study hormone levels.
  4. Urography. It is carried out for the need for concomitant pathologies of the genitourinary system.

Varicocele 1 degree: treatment?

Varicocele of the 1st degree has virtually no symptoms, so it is often diagnosed by chance. Sometimes men notice an increase in the scrotum. To the touch you can feel the veins appear and harden. If these signs appear, you must immediately consult a doctor.

What is the difficulty of diagnosing the disease in the initial stages?

Every man should know which doctor he needs to contact if they detect signs of varicocele. First of all, this is a urologist, that is, a specialist who treats exclusively male ailments. In addition to the urologist, you can turn to the andrologist.

The methods that the doctor uses for diagnosis are quite diverse.

At the initial stages, varicocele is difficult to determine, since the disease does not yet have obvious manifestations.

Swollen veins can be determined by touch, and ultrasound is used to clarify the diagnosis. Ultrasound can detect the size of the testicle, the nature of blood flow, the formation of nodes. Methods such as dopplerography and spermography are also used.

Below you can find a photo of the first degree varicocele.

The main thing that the patient must understand is that varicocele must be treated. The body alone is not able to cope with it even at the first stage.

Varicocele 1 degree: treatment without surgery is possible? Treatment should be comprehensive, that is, surgery is accompanied by medication. Surgery can be dispensed with if the disease does not cause a man discomfort. That is, it does not interfere with a full life, have children, etc.

Definition of varicocele

Varicocele is a varicose vein that forms the sphenoid (papillary) plexus of the testicle. The word "varicocele" in Greek means "a tumor of venous nodes." Such a pathology is quite common among all age groups, but 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 is manifested in 40% and in 80% of men with secondary infertility, that is, those from whom women already had offspring.

Potential patients

Varicocele is more often found in people with certain anatomical features or a hereditary disposition. According to statistics, the disease affects 15% of men.

The risk group is represented by the following potential patients:

  • teenager 14-17 years old
  • a man from 20 to 40 years old,
  • old man.

In adolescence, anatomical and genetic factors come to the fore. Over the years, the disease often worsens or is just beginning to develop under the influence of irritants.

Do I need an operation

Everyone solves this problem for himself. However, if a person is concerned about the issue of childbearing, it should be borne in mind that only surgical intervention is a real method of restoring reproductive health for people suffering from varicocele.

The meaning of the operation is to stop the return of blood from the channel of the affected veins into the sphenoid (pinnate) plexus. In ancient times, the affected veins in the region of the spermatic cord on the patient's testicle were squeezed with forceps directly through the skin, and then burned with iron. Now there are many more humane surgical methods for treating varicocele.

Characteristic symptoms

There are 3 degrees of varicocele depending on the severity of varicose veins of the spermatic cord. Varicose veins of the 1st degree - the plexiform plexus is increased, but this can only be determined by palpation of the scrotum during straining.

2 degree of lesion is characterized by a visual increase in half of the scrotum, expressed by palpatory changes in the veins of the testicle when moving to a standing position and straining. If the disease went into grade 3, then atrophy, a decrease in the size and density of the testicle, as well as changes in the spermogram, join.

Symptoms of varicose veins of the spermatic cord of the 1st degree are scarce. May be disturbed by slight discomfort in the scrotum on the affected side, the patient himself, and most often the surgeon during examination, determines a soft formation in the back of the testicle, increasing due to filling with venous blood, when moving from a lying position to a standing position.

In many cases, there are no complaints, and the first sign is the discovery of male infertility.

Is it possible to treat this stage with medicines and procedures?

Treatment of the disease at this stage consists in wearing a special dressing or special underwear. As for drug treatment, the basis for a complex of drugs is prescribed after the operation. And as a non-surgical treatment, the urologist prescribes angioprotective and venotonic agents.

They reduce the extensibility of the venous walls and eliminate congestion. The most effective among these drugs are Venarus, Phlebodia and Venoruton.

A mandatory part of the treatment is taking medications with a high content of vitamins. These are Rutozid and Ascorutin.

A positive effect on venous tone is medical gymnastics. For treatment, a specially developed set of exercises is used, which is aimed at the outflow of blood and the strengthening of blood vessels. First of all, it is squats, bends, etc. Respiratory gymnastics is also effective.

Identify early-stage symptoms

Varicocele appears gradually due to increased venous stasis. The man begins to feel discomfort in the groin area and may notice visible changes. The following symptoms are typical for an early stage:

  • The appearance of mild pulling pain in the testicles and groin.
  • Identification of varicose veins of the spermatic cord during palpation.
  • One-sided enlargement of the scrotum.

At an early stage, varicocele does not actually appear. A man learns about a problem mainly during a comprehensive examination. Diagnosis is usually made to find the reason why the spouse cannot become pregnant. The clinical picture is aggravated with the further development of the disease.

Diagnostic Methods

The diagnosis of varicocele is made primarily on the basis of a palpation examination of the scrotum by the surgeon in the patient's supine position, standing, with straining.

Confirm the assumption helps ultrasound examination of the scrotum with Doppler scanning. It reveals the reverse flow of blood into the plexiform plexus. During this study, a Valsalva test is performed: the patient takes a deep breath and holds his breath for 10-15 seconds, which additionally increases blood flow to the scrotum.

To exclude developmental abnormalities and neoplasms of the kidneys, renal vessels, and ureters, ultrasound of these organs and magnetic resonance imaging of retroperitoneal organs are performed.

The effect of varicocele on the reproductive function of men is studied by studying the quality of sperm - sperm. The main indicators of a normal spermogram:

  • volume 2.0-6.0 ml
  • pH 7.2-7.8
  • sperm concentration> 20 million / ml,
  • the number of viable forms> 75%,
  • sperm agglutination (gluing) should be absent.

Conservative treatment

A special dressing or underwear will help get rid of varicocele of the first degree. Treatment is carried out with normal blood flow inside the organ.

Assigned funds aimed at eliminating venous insufficiency. These include:

  • Preparations that increase the tone of the vascular wall,
  • Antioxidant products
  • Medicines to improve the quality characteristics of blood.

To speed up the healing process, oxygen therapy courses are administered, which is supplied under high pressure. This method is carried out under ultrasound control.

In addition to the use of drugs for oral administration, external methods of treatment are also effective. Your doctor may prescribe anti-inflammatory ointments to help reduce pain. Their application is combined with a light massage of the affected area. This procedure is carried out twice a day.

Holding the right massage helps to cope with the anomaly in the male genital organs with stages 2-3 of the pathology. To carry it out, it is necessary to lie in the gluteal region on a pillow or roller. The man begins to gently rub the testicle, the groin area. Such work will reduce pain, improve tissue nutrition.

Another method is to use a suspensorium. The technique is aimed at maintaining the testicle in an elevated position. This improves blood flow, removes the feeling of discomfort. Such a supporting device consists of a tight belt and knitwear. It has an opening for the male genital organ.

Additionally, the patient may be prescribed swimming in the pool and taking vasoconstrictor drugs. To obtain a faster result from the course of therapeutic measures, it is recommended to carry out the prevention of flatulence and constipation.

Symptoms of varicocele

In the initial stages, varicocele can be asymptomatic. Only pain in the scrotum and testicle, intensifying as the disease progresses, can ascertain its appearance. As a rule, patients experience a pulling pain in one or both testicles, scrotum, in the inguinal zone, an increase or omission of the scrotum is observed on the left side.

Pain sensations intensify with physical exertion, walking and during intercourse. The disease is very dangerous for men of reproductive age. Testicular varicocele disease can have a chronic course. Often, a deviation from the norm in many men is an accidental finding when examined for any other disease.

Differential diagnosis of the first degree of varicocele

To make a diagnosis and draw up a treatment regimen, a patient with suspected varicocele must consult a urologist. The doctor will interview the patient and conduct an examination.

If nodules are found on the veins of the spermatic cord, you will definitely need to be examined:

  • ultrasound procedure,
  • blood donation to determine the concentration of hormones,
  • radioisotope studies,
  • urography and phlebography,
  • sperm delivery for analysis.

Other diagnostic methods may be prescribed depending on the situation. The main task of the doctor will be to identify the causes of venous stasis.


  1. The absence of pronounced symptoms of the disease (only in cases where the issue of further childbearing is unimportant).

Secondary varicocele caused by the occurrence of inflammatory processes in other human organs, or due to the influence of neoplasms.

  • Standard contraindications for any surgical operation.
  • In our country, the following 4 main types of operations are now practiced:

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    • Excision of damaged sections of blood vessels according to the methods of Bernardi, Kondakov, Palomo and Ivanissevich,
    • Microsurgical (performed through access to the inguinal region using optical equipment),
    • X-ray endovascular
    • The use of vascular anastomoses.

    Is it possible to do without surgery

    Discussions continue about whether surgical treatment for varicocele, especially in childhood, up to 18 years of age is necessary.

    Most authors adhere to the tactics of observing children with an identified disease, as there is evidence that with the onset of puberty, the size of the plexiform plexus can spontaneously decrease.

    After 18 years, indications for surgery are:

    • the presence of varicocele, clinically and instrumentally confirmed,
    • changes in the spermogram,
    • atrophic changes in the testicle,
    • pain in the scrotum in the absence of other causes than varicocele.


    Treatment of varicocele 1 degree with conservative methods, according to foreign doctors, is not always effective. The feasibility of the operation depends on the failure of the reproductive function, systematic pain, changes in the spermogram.

    The purpose of surgical treatment is to reduce or completely get rid of the return of biological fluid from the channel of the affected veins. Such events were held in ancient times. Then there was a clamping of the affected veins in the area of ​​the spermatic cord on the man’s testicle with special forceps, after which the area was burned with a hot iron.

    Contraindications to the operation include:

    1. The absence of pronounced signs of the disease,
    2. Secondary varicocele, which appeared against the background of the inflammatory process,
    3. The presence of acute infection in the body.

    What lifestyle should I follow so that 1 degree does not turn into 2?

    Prevention of the disease is very important, since it can very easily go varicocele from 1 to 2 degree and give complications. Necessarily necessary:

    1. Eat right, eliminating harmful and fatty foods from the diet. Food should be rich in vitamins and minerals.
    2. Make sure that there are no constipation, as they lead to the appearance of congestion in the pelvis.
    3. Reduce the amount of alcohol consumed and quit smoking. These bad habits directly affect vascular health.
    4. Sexual life should be regular and protected.
    5. Prevent the development of thrombosis.
    6. Make sure that there is no excessive physical stress. But playing sports is necessary, as moderate physical activity strengthens blood vessels and increases immunity.
    7. Wear such underwear and clothing so that they do not disturb blood circulation.

    Stage 1 varicocele is not a fatal disease, but it can lead to poor men's health. The main problem is possible infertility, therefore, at the first symptoms of the disease, you must consult a doctor.

    1, 2, 3, 4 degrees of varicocele

    There are four degrees of varicocele:

    • Grade 1 - varicose veins are determined only using an ultrasound device or Doppler ultrasound method.
    • 2 degree - the expansion of the vein is felt in a standing position.
    • Grade 3 - dilated veins are felt in any position while standing or lying down.
    • Grade 4 - the expansion of the veins of the testis and spermatic cord are visible during visual examination.

    Varicocele appears in adolescents during puberty, upon reaching some degree is no longer exacerbated. It is extremely rare to go from one degree to another. Varicocele on the right or on both sides is a rare occurrence.

    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 credibility.

    Treatment of intimate male pathology

    Surgery is the most effective treatment for varicose veins. Other methods are relevant if the disease does not disturb the patient, does not develop and does not provoke complications.

    To understand whether surgery is necessary for varicocele of the 1st degree, the generally accepted criteria for the need for radical therapy will help:

    • The diagnosis is confirmed by instrumental.
    • The spermogram revealed abnormalities.
    • Testicular atrophy began.
    • The patient is worried about severe pain in the scrotum.
    • The testicle stopped growing in the child against the background of the appearance of varicocele.
    • The patient wants to remove the aesthetic defect.
    • A man suffers from infertility due to the negative impact of a stagnant process in the veins on sperm synthesis.

    Many doctors try not to perform operations in children because of information about the likely decrease in the sphenoid plexus when the onset of puberty. As a treatment, other methods are used.

    Varicocele 1 degree left

    Varicocele can be bilateral, or affect the right or left testicle of a man. However, the anatomically structure of the body is such that in most cases it is the left side that is affected. This is due to the fact that the spermatic vein on the left connects to the renal vein at an angle close to the straight line.

    Varicocele of the 1st degree does not mean a man’s sentence of infertility. The reproductive function is affected by many factors, and this is just one of them. However, observations show that 4 out of 10 men with varicocele 1 degree have problems conceiving. It is worth seriously taking such a possible appearance and taking measures to treat the disease in advance.

    Do they take into the army

    For a young man in our country, a diagnosis of varicocele of the 1st degree is not a withdrawal from military service. With such a diagnosis, they take to the service. Also, this diagnosis is not an obstacle to admission to the military department of an educational institution. Guys should know about this and be prepared for the commission in advance. They will take you to the army.


    In modern urology, a number of techniques are used for this disease, aimed at normalizing the blood supply to the testicle:

    1. Endovascular embolization of the testicular vein. An intravascular catheter is inserted through the femoral vein under radiological control, it is advanced into the testicular (testicular) vein at a distance of 5-8 cm and a preparation is introduced that scleroses (closes) the lumen of the affected vessel. Laser destruction of the affected areas of the veins through vascular access is also possible.
    2. Marmara's operation (varicocelectomy). An incision is made above the spermatic cord, and carefully, one at a time, all affected scrotum vessels are ligated and dissected.
    3. Operation Ivanissevich. An incision is made of the anterior abdominal wall above the inguinal canal, all veins passing in the inguinal canal are ligated and dissected. This operation is the most common in our country.
    4. Operation Palomo. The difference with the previous operation is that the surgical access is 10 cm higher and the testicular artery intersects along with the veins. This option is also implemented with laparoscopic access to the operation area (pictured).

    All operations are less traumatic, and in the absence of complications, patients quickly recover. It should be noted that operations with varicocele in a fairly large number of cases still lead to a relapse of the disease (from 7 to 40% of cases). The smallest relapse, according to statistics, occurs after microsurgical varicocelectomy.

    What surgical techniques are used

    One of the most effective methods is sclerotherapy and embolization. An intervention is performed under intravenous anesthesia or local anesthesia. A catheter is inserted first. Using hardware monitoring, he advances to the renal vein area. Upon reaching the desired location, a contrast agent is introduced.

    As it spreads through the circulatory system of the pelvis, the enlarged internal vessels reaching the testicle become clearly visible in the pictures. After this, the catheter is inserted down to the inguinal inner ring. Through it, special plates or balls are inserted that block the veins. In small vessels, drugs are introduced that glue the walls of the vessels.

    A sterile dressing is applied to the puncture area.In some situations, doctors decide to stitch.
    Such minimally invasive intervention is effective, since the likelihood of relapse decreases, and it becomes possible to eliminate infertility. Unlike conventional operations, the recovery period takes only up to 2 days.

    Other types of surgery may also be prescribed for varicocele 1 degree. These include:

    • Bypass surgery. A special element is introduced that expands the vessel wall to restore full blood flow.
    • Marmara surgery. A testicular vein is transplanted into the epigastric.
    • Endoscopic approach. Ligation of vessels using a laparoscope.
    • The operation according to the method of Ivanissevich. This is an open impact of the surgeon when a site in the area of ​​the inguinal canal is bandaged.

    Varicocele treatment - operation

    Only surgical treatment of varicocele is effective. Direct indications for surgery are stage 3 disease, pathological changes in the spermogram. Three operational approaches are used:

        • ligation of the dilated veins of the spermatic cord. The procedure is performed using a cut at the entrance to the inguinal canal, at the exit of the inguinal canal, in the inguinal canal itself. In recent decades, sparing microsurgical and endoscopic techniques have been actively used, in which the cut length does not exceed 2 cm.
        • embolization and sclerosis - use the endovascular procedure, during which the expanded veins of the spermatic cord are filled with a special drug. There is a blockage of the lumen of the vein and / or fusion of its walls.
        • testicular raising - rarely used due to relatively low efficiency.

    The recovery period after an open operation to remove varicocele lasts up to 1 month, after an endovascular surgery, the operation lasts less than 1 week.

    Complications after surgery to remove varicocele occur in 5-7% of cases: dropsy of the testicle (hydrocele, lymphostasis), inguinal hernia. All of these complications are reversible, with the exception of extremely rare cases of inguinal hernia.

    How to treat varicocele on the left testicle? The only effective treatment is surgery. Since this disease does not belong to the category of dangerous ones, there is no direct indication for surgical intervention. This is only necessary in the following cases:

    • persistent pain in the testicle
    • to eliminate the defect in the scrotum, giving it an aesthetic appearance,
    • treatment of male infertility.

    However, many experts are inclined to the common opinion that if varicocele is detected in children and adolescents, then the operation must be done to eliminate potential infertility.

    To date, the operational method of treating this disease is presented in four ways:

    • open operation (according to Ivanissevich),
    • endoscopic surgery
    • operation from mini-access,
    • microsurgical revascularization of the testis.

    Surgical intervention

    The essence of the operation is to close the affected vessels. Venous congestion is eliminated, which helps to fully restore testicular function.

    One of these types of interventions is carried out:

    • Palomo operation
    • varicocelectomy,
    • Ivanissevich operation,
    • endovascular embolization.

    Treatment methods

    It is impractical to question the need for varicocele therapy of the 1st degree due to the high risks of complications. It is important to remember that it is necessary to treat the expansion of the veins of the testicular structure. Already at the first stage of the disease, doctors recommend surgery.

    The method is recommended for patients who want to have children in the future without any difficulties. The following types of operations are used for this:

    1. Open (ligation of the vein over the inner ring of the inguinal canal).
    2. Revascularization (transplantation of the testicular vein to the epigastric).
    3. Laparoscopic (ligation of the testicular vein).
    4. X-ray endovascular (the introduction of special substances to block the vein).
    5. Bypass surgery (insertion of a shunt into the affected testicle for outflow of blood surplus).

    After surgery, the intake of vitamins helps speedy recovery. Varicocele 1 degree also suggests conservative therapy. If you follow medical advice, sometimes surgery can be avoided.

    Conservative methods of treatment include:

    • taking medications that narrow the blood vessels,
    • regulation of sexual contacts,
    • exclusion from the use of alcoholic beverages,
    • swimming lessons
    • physiotherapy,
    • wearing tight-fitting underwear,

    It is recommended to perform therapeutic gymnastic exercises, as well as taking medications that strengthen the walls of blood vessels that improve blood microcirculation.

    Varicocele after surgery: complications

    Since operations of this type have been practiced for a long time, complications are rare. Here are the main ones:

    • Atrophy (malnutrition). Despite the rarity of such cases, this is the most formidable complication that negates the meaning of the operation itself,
    • Lymphostasis of the scrotum. Swelling of the scrotum, which usually disappears completely in the first few days after surgery,
    • Pain syndrome. Occurs in less than 5% of cases. As a rule, it is quickly stopped by antibacterial and anti-inflammatory drugs,
    • Hydrocele. Slight fluid retention. It usually disappears completely within a year after surgery,
    • Complications of laparoscopy
    • Relapse of varicocele (more commonly seen in adolescents).

    Possible complications

    The complications of varicose veins of the spermatic cord include:

    1. Testicular atrophy. Due to a violation of the blood supply, the testicular tissues are reduced, sclerosed, replaced by connective tissue.
    2. Infertility. 40 out of 100 men with diagnosed infertility find varicocele. An important role in the formation of a violation of spermatogenesis belongs to antisperm antibodies, which are released into the bloodstream when one testicle is damaged and attack the spermatozoa of a healthy testicle, leading to impaired reproductive function.

    During and after surgery for varicocele, complications can also develop. These include:

    1. Damage to arteries, bleeding. In most cases, this complication is recognized and eliminated on time without serious consequences for the health and life of the patient.
    2. Damage to nerves leads to loss of sensitivity of the skin of the scrotum on the side of the operation.
    3. Infectious processes (thrombophlebitis, orchoepididymitis).
    4. Dropsy of testicular membranes develops with joint damage to the lymphatic vessels of the spermatic cord, a second operation is necessary.
    5. Relapse of varicocele occurs, according to statistics, in 7-40% of cases of surgical interventions. The lowest relapse rate is described after microsurgical varicocelectomy.

    Varicocele Prevention

    Prevention requires due attention to patients of any age. Painful vein expansion in children can be congenital and acquired. Most often found varicocele 1 degree. Parents of boys should be aware of the possibility of such a pathology, since a rare teenager will deal with this issue independently.

    Medicine does not provide for conservative treatment and prevention of the disease. Otherwise, the disease could have been eliminated without surgery. However, indirectly strengthening immunity, while eliminating provoking factors, slows down the course of the disease. Key preventative measures include:

    • dietary compliance (minimize the use of fatty, salty, fried foods, include more plant foods),
    • rejection of bad habits,
    • treatment of diseases of the digestive system,
    • physical exercises without lifting weights,
    • to exclude a long stay in a standing or sitting position, provoking stagnation of blood of the pelvic organs,
    • control body weight.

    Prevention involves enhancing the blood circulation of the testicular veins, eliminating factors that worsen the activity of the circulatory system, as well as preventing the increase in pressure of the genital and neighboring organs.

    Young men need to be examined by a urologist. By this time, puberty is completed, if varicocele is not detected, the further appearance of the disease does not threaten.

    The effectiveness of other therapeutic methods

    Non-surgical treatment of varicocele of the 1st degree involves the exclusion of irritants and the appointment of supporting procedures. To prevent the transition of the disease to a new stage, it will be required to be examined annually. The list of effective methods of therapy is given in the table:

    Method of treatmentDescription
    Taking medication• Medications for constipation (Lactuvit, Forlax, Dufalac).
    • Venotonic agents (Phlebofa, Phlebaven, Detralex).
    • Means for the fight against flatulence (Espumisan, Pepfiz, Antareyt).
    • Vitamin complexes ("Centrum", "Herbalife", "Alphabet").
    • Antioxidants ("Antiox", "Mexipril", "Synergin")
    • Ointments, gels, creams to increase the tone of veins and relieve pain (Troxerutin, Venolife, Troxevasin).
    The use of folk remedies• Tinctures and decoctions of apples or horse chestnut.
    • Compresses and lotions.
    • Therapeutic baths.
    The use of physiotherapeutic methods• Ultrasound therapy.
    • Magnetotherapy.
    Diet correction• Need to eat more:
    - low-fat varieties of meat and fish,
    - vegetables, fruits, berries,
    - whole grain cereals.
    • To be excluded from the menu:
    - smoked and fried foods,
    - alcohol
    - coffee and energy,
    - carbonated drinks,
    - flour
    - fatty dishes.
    Other methods• Wearing special underwear.
    • Frequent dousing of the scrotum with cold water.
    • Massaging the testicles.
    • Performing gymnastic complexes.

    Treatment will be more effective if the patient observes preventive measures and periodically comes to see a doctor. With an aggravation of the clinical picture, it will be necessary to change the treatment regimen.

    The consequences of the disease and forecasts

    Varicocele of the 1st degree rarely goes to another stage and does not actually provoke infertility. Certain problems with conception are found only in 35% of patients. In other cases, the disease is asymptomatic and does not require special treatment.

    After surgery, the crib is restored, but there is a likelihood of complications in the postoperative period:

    • testicular atrophy,
    • infection development
    • relapse of the disease.

    The appearance of undesirable consequences can be avoided by following the doctor's recommendations. If you do not lift weights, exclude sexual activity, change the dressings daily, then a full recovery will soon come.


    Due to the fact that the blood controls the temperature, an increase in its volume in some nodes provokes their overheating. Varicocele of the 1st degree is accompanied by an increase and proliferation of the venous network of the affected testicle, which provokes an increase in its blood filling.

    Varicocele of the 1st degree is accompanied by an increase and proliferation of the venous network of the affected testicle

    The result is an incorrect, or rather, non-standard temperature of formation of seminal fluid, which suggests being at 32.5-34.5 °. Overheating of the urogenital organs of a man adversely affects reproductive function.

    Varicocele is characterized by overheating, which increases the risk of the disease. The danger of developing infertility in the pathology of the first stage is equal to the risk formed in the 4th. The main difference in the pace of development of such problems. With a deep lesion of the testicle, infertility develops faster.

    We carry out prevention

    Prevention of variacocele consists of measures aimed at stopping the development of the pathological process. The main emphasis is on maintaining the body in good shape and the fight against provocateurs of venous stasis.

    You can focus on the recommendations of experts:

    • adjust the diet,
    • Schedule a sleep-wakefulness
    • normalize the work of the gastrointestinal tract,
    • avoid physical inactivity
    • control body weight
    • try not to stand and sit for a long time,
    • Avoid heavy physical exertion.

    Following preventive measures, the patient will reduce the risk of the disease moving to a new stage. Additional information must be provided by the attending physician.

    At the first stage, varicocele is sometimes manifested by mild pain or is completely asymptomatic. The disease is determined by palpation and the appointment of a number of examinations. As a treatment, surgery is most effective. Other methods only do not allow reinforced venous congestion.

    Are there any complications after surgery?

    The frequency of their occurrence is small, since all the techniques used are well-developed by doctors. In some cases, atrophy occurs. This is the most dangerous complication, due to which the meaning of the treatment is completely lost. There are also temporary complications. These include swelling of the scrotum. It usually disappears on its own a few days after the intervention.

    In 5% of cases, pain appears. This complication is stopped by antibiotics and anti-inflammatory drugs. Sometimes a slight fluid retention occurs. This problem disappears within 12 months after surgery.


    Alternative medicine methods are often used additionally. At the first stage of varicocele, you can try:

    1. Horse chestnut tincture. It is sold in a pharmacy. It is necessary to use twice a day for 30 drops. They are washed down with plenty of water.
    2. Apple broth. Three apples are boiled for 30 minutes in 2 liters of water. The resulting broth is infused for three hours. You need to use it in the morning and evening, one glass each.
    3. Wormwood Compresses. A handful of fresh grass leaves is taken. Two spoons of unsweetened dairy products are added to it. Gruel is applied to gauze, applied to the affected side.

    Traditional medicine

    With varicocele 1 degree, you can take decoctions

    At the first stage, varicocele can be treated with traditional medicine. There are many different recipes based on medicinal herbs and other useful natural ingredients. Use of home medicines is possible only with the permission of the attending physician.

    With varicocele 1 degree, you can take decoctions. A horse chestnut based product has a good therapeutic effect. To prepare, take a tablespoon of the plant, pour a glass of boiling water, boil for 5 minutes. Allow the drink to infuse for 4 hours, after which it is filtered. Take a decoction of 50 ml per day on an empty stomach.

    Wipe with folk remedies. For this, oil with St. John's wort is often prepared. A large spoonful of grass is poured with a glass of corn oil, kept for 3 hours in a water bath, insisted for 8 hours and filtered. The resulting product treats the affected part of the body. Wipe three times a day.

    With variocele 1 degree left or right, it is recommended to carry out sedentary baths. Thanks to them, the feeling of heaviness is eliminated, the state of blood vessels is normalized, and a calming effect is produced.

    For the bath, you can prepare the following broth: mix the crushed oak, willow and chestnut bark in the same amount, separate 150 g of the mixture, pour 3 liters of hot water, boil for 30 minutes. Then add 2 tablespoons of chamomile, pineapple and hypericum.

    Allow the product to infuse for 12 hours, strain, heat to a temperature of 40 degrees, pour into a bowl and sit for about 15 minutes. It is advisable to carry out the procedure before bedtime daily.

    Well increases the tone of the vessels of the bath with a decoction of calendula. For cooking, you need a handful of plants to brew a liter of boiling water, insist for a couple of hours, strain and use for baths, after adding cold water.

    Attention! In no case should one abandon the traditional methods of therapy in favor of folk remedies. Home remedies are only an auxiliary way to treat varicocele of the first degree.

    How to prevent the transition of 1 degree of the disease to 2?

    In order for varicocele of the 1st degree not to go to the next stage, the following recommendations of specialists should be observed:

    • Regularly undergo a medical examination to monitor the development of the disease.
    • Go in for sports, do exercises daily.
    • Regularly have sex.
    • Eat right, giving up all harmful foods.
    • Monitor the normal state of the digestive system so that there is no constipation.

    Such simple tips will help slow down the progression of the disease and successfully get rid of it without complications.

    Disease prevention

    Doctors recommend playing sports, eating rationally and regularly visiting a urologist

    Varicocele 1-2 degrees is better to prevent, since in the future it can cause unpleasant consequences. To prevent the development of pathology, doctors recommend the following:

    1. Go in for sports, but avoid overworking the body.
    2. Do not get involved in cycling.
    3. Stop smoking and drinking alcohol.
    4. Eat rationally.
    5. Do not lead a sedentary lifestyle.
    6. Keep track of body weight.
    7. Timely eliminate problems with the stool, namely constipation.
    8. Do not ignore diseases of the reproductive system.
    9. Have sex regularly.

    Varicocele 1 degree - the mildest form of pathology of the genital organs in men. It is not accompanied by clinical manifestations, only instrumental research will allow to identify the disease. Therefore, doctors advise men to regularly visit a urologist for preventive purposes.

    Varicocele: forms and degrees, treatment, prevention

    Varicocele is a common pathology that is detected in almost half of the men examined due to infertility. It is characterized by venous insufficiency and dilatation of the scrotum.

    Four degrees of the disease are distinguished: the first two do not bother the patient, the rest require surgical treatment.

    At the 3-4th degree, the risk of possible complications is high, which can affect not only fertility, but also the general health of the man.

    Varicocele is a pathology in which varicose veins of the spermatic cord occur. There are two main forms:

    • Idiopathic. It develops most often with severe physical exertion and prolonged standing on the legs, which is the cause of increased pressure in the kidneys, which leads to weakness of the walls of the veins and the disease. Surgical treatment.
    • Subclinical. Pathology with this form does not occur. A man seeks help only with a prolonged absence of pregnancy in a partner. The disease does not have specific symptoms, it can only be diagnosed with ultrasound.

    Before choosing a treatment method for the second form, screening is mandatory. Based on it, the method of therapy is determined.

    The degree varies depending on the severity of vasodilation:

    FirstNot accompanied by any symptoms. A diagnosis can only be made using dopplerography, palpation is not informative. In a recent study, the number of live sperm and their motility, density and volume of ejaculate is determined
    SecondPathology can be felt, dilated veins protrude. This is accompanied by an increase in the gonads, pulling pain in the testicle and groin, which intensifies after exertion. Corrective treatment or surgery may be prescribed.
    ThirdVaricose veins are visible to the naked eye. The skin of the scrotum is like a dough, deformed. There is swelling of the genital glands. Cramps and burning during urination, which is accompanied by pathology, are not removed even by painkillers. This is a severe form of pathology, surgical intervention is necessary.
    FourthDilation of the veins leads to the fact that the pain becomes unbearable. Pathology poses a serious threat to fertility, irreversible changes in blood flow and blood vessels are observed. At this degree, varicocele is operated on, but the effectiveness of therapy depends on the progression of the disease. If more than five years have passed since the change began, then the probability of recovery is low.

    They take into the army with the 1-2 degree of the disease, the 3-4th are exemption from military service, but only in peacetime.

    Pathology most often covers the left testicle, in 9% of patients a bilateral disorder is diagnosed, and only 3% have a right-sided disorder. Each variety has features:

    The formDescription
    Left-sided pathologyThe cause is the individual anatomy of the circulatory system. The renal vein is in close contact with closely localized vessels that press it. Changes on the left due to heredity
    Right sideIt arises as an independent disease, which is a consequence of the pathology of the inferior vena cava. It is caused by prolonged sitting, lack of exercise, malnutrition. It does not have vivid manifestations. May be accompanied by discomfort in case of exertion.
    Double sidedIt is rare, is an expansion of the veins localized between the testicle and the internal inguinal ring. Symptoms are different, mainly pulling pains. Pathology on the left side is brighter

    A feature of the disease in children is the imperfection of venous blood flow. The disease develops in 6% of boys aged ten years.

    There is a strong expansion of veins with pronounced tortuosity, resulting in the formation of a plexiform plexus. The reasons for the development of the idiopathic form are the anatomical and genetic features, sexual arousal experienced by the growing organism and the associated stagnant phenomena. There is no convincing evidence of any effect of masturbation and wearing diapers.

    At this age, the disease is not accompanied by pain or other unpleasant sensations. Occasionally, the scrotum or testis becomes blue. Pain is only possible for a short time. As in adults, damage to the left testicle is more common. Right-sided varicocele rarely develops, due to the discharge of vessels into the vena cava.

    In adolescents, the disease manifests itself at the peak of puberty due to a strong increase in blood supply in the glands. It may be accompanied by painful sensations, intensifying during an erection or after exertion.

    With significant progression of the disease, the scrotum can sag and interfere with movement. Most often, the disease is detected in the period 12 to 14 years, when the boys undergo a draft board.

    Self-diagnosis is easy. Symptoms of varicocele include:

    • scrotum enlargement,
    • feeling pain
    • vascular compaction,
    • their protrusion through the skin.

    About 40% of men with diagnosed infertility find this disease. The quality of the ejaculate and the activity of gametes is deteriorating due to impaired blood flow and a malfunction in the temperature control system. Sperm cells change in morphology, become less mobile, this leads to infertility.

    The main signs of varicocele are:

    Sagging scrotumThe symptom is noticeable when walking, as it causes inconvenience. A feeling of heaviness in the groin area is added to it. It becomes difficult to determine the localization of pain
    Pain and burning in the testicleThe symptom is replaced by a feeling of heaviness. Accompanied by pains and stitching pains. Sensations spread along the spermatic cord. Later they move to the lower back or penis
    Increased discomfort in the evening or after exerciseAt the 3rd stage of the disease, unpleasant sensations annoy even at rest. Sometimes the testicle can vary in size.
    Loss of performanceMany patients notice worsening of health, sexual weakness, causeless fatigue. Efficiency decreases, appetite loss is observed, all this is accompanied by frequent urges to empty the bladder and even enuresis

    In severe stages, the patient complains of severe fatigue.

    Most often, men go to the doctor for a late stage of the disease. In this case, there is almost no need for diagnosis, since the urologist can easily detect varicocele by palpation and examination. If in doubt, carry out additional activities.

    To make a diagnosis, instrumental methods are used, with which you can accurately identify the degree of the disease and determine its features:

    Research methodDescription
    Ultrasound diagnosis of testicular veinsProduced in conjunction with dopplerography. Determined by the throwing of blood into the seminal canal. The features and consequences of the disease are analyzed. With a vessel diameter of more than 2 mm, they speak of varicose ovarian veins. In a healthy man, this parameter will be less than 2 mm, and blood flow velocity - not more than 10 cm / s
    Sex hormone testsEstimated levels of follicle-stimulating hormone, estradiol and testosterone
    March testIt consists in passing a laboratory analysis of urine before exercise and after. The technique is considered effective if necessary to diagnose venous insufficiency. The disease is confirmed if there are red blood cells and protein in the second sample.
    SpermogramAssigned to sexually mature men. With varicocele, there is a decrease in the number of sperm and their lack of activity
    Other studiesThis category includes serological testing and Valsalva

    In order to diagnose the pathology yourself, it is necessary to examine the testicle and scrotum. With the following symptoms, you should consult a doctor: noticeable cosmetic defects, resizing or the appearance of pain in the testicle, groin and scrotum when touched.

    To recognize the disease at an early stage and prevent its further development, you should independently examine the scrotum and testicles. It is necessary to pay attention to the thickening and sinuosity of blood vessels, tingling, intensifying in the evenings, to feel the scrotum for an increase in the right or left half.

    It is impossible to conduct a self-diagnosis of varicocele solely on these grounds; at the initial stage, the disease is not accompanied by symptoms. But thanks to a regular examination, one can also notice manifestations of other pathologies that also require timely qualified treatment.

    If the disease is manifested by pain in the scrotum and infertility, there is a need for surgery in the shortest possible time. In the absence of complaints, changes in the spermogram and if the man does not want to have children, surgical intervention can be dispensed with.

    The main method of treatment

    There are several basic methods of therapy:

    Traditional operationAlso called the operation according to Ivanissevich. It consists in the intersection or removal of the affected vein. Made through cuts 3-5 cm wide
    Endoscopic surgeryProduced through 3 small punctures in the abdomen. An endoscope is inserted through one of them, the vessel is ligated.The duration of the procedure is about 15-20 minutes
    Sclerotization of the veins of the spermatic cordIt consists in filling the vessel with sclerosing substance with endoscopic access. The benefits of this type of surgery are low blood loss and quick recovery.
    VaricocelectomyRefers to microsurgical techniques. It is made through a small incision in the inguinal region, in the hair growth zone using a special tool.

    Varicocelectomy: photo through an endoscope

    Rehabilitation takes a month. During this period, it is necessary to exclude intimate contacts, reduce the use of salt, bitter and spicy dishes. Loads should be moderate.

    Among the possible complications after surgery, there is stagnation of lymphatic fluid in the tissues of the testis, edema, pain, dropsy. This goes away after a while.

    The type of intervention plays a significant role. With more gentle (microsurgical and laparoscopic) methods, there is no violation of the integrity of the vessel walls, the probability of testicular atrophy and reproductive function pathologies is reduced. Modern techniques reduce the possibility of relapse.

    Operations to eliminate varicocele are prescribed in such cases:

    • with a decrease in the testicle in size,
    • if you feel uncomfortable
    • with a decrease in the qualitative and quantitative indicators of sperm.

    In all other cases, it is only necessary to see a urologist every 6 months.

    Treatment without surgery is possible only at the initial stage, when it does not threaten with serious consequences. Ignoring the problem with severe pathology can lead to impaired sexual function.

    The techniques are applied after proper examination and consultation with a doctor.

    Exercise helps restore normal blood flow through the veins. You can effectively get rid of pathology at home using the following methods:

    • The most effective is throwing legs on the wall. In this position, you need to stay more than 15 minutes. This should be done while lying on the bed or on the floor.
    • Another exercise is performed while standing on toes. It is necessary to carry out inclinations, trying to reach the toes. Exercises should be performed daily.

    None of the conservative methods can produce the same effect as surgery. But you can slow down the disease and prevent complications.

    At the initial stage of development, it is allowed to use massage, which helps to drain excess blood. The use of a bandage or special underwear may be recommended. This makes it possible to slow the progression of pathology.

    Folk remedies are used after examination by a doctor and only as an auxiliary technique. They can not completely cure the disease, but they contribute to a significant reduction in the severity of symptoms.

    Wormwood-based compress helps relieve discomfort and swelling. 1 tbsp. l ground raw material, dried, mixed with the same amount of fat sour cream, is applied to the affected area. The compress is covered with a natural cloth and holds for about half an hour, after which it is washed off with warm water. The procedure is carried out daily, the course of treatment is 5 days.

    Used and collecting herbs. Willow bark, chestnut, chamomile, raspberry and millennials are mixed in equal proportions. 1.5 tbsp. l raw materials are poured with 2 glasses of boiling water. The tool is infused in a thermos for 10 hours. The composition is divided into 2 parts and is taken in the morning and evening half an hour before meals.

    Varicose veins of the testis in men is dangerous, since without proper treatment it can lead to serious complications. Often, pathology provokes a violation of the lymph flow and permeability of veins. Processes can cause the formation of dropsy of the testicle. If there is a violation of the outflow of blood, decay products begin to accumulate, which leads to a deterioration in the functionality of the testicles.

    In the field of pathology, blood clots may form. Blocking blood flow leads to trophic damage to the organ.

    The disease is very common, often diagnosed in children, but mainly of the first degree. In approximately 10% of the examined, a second degree of the disease is detected, and the 3rd in 5% of adolescents. At this age, pathology can be treated with medications that improve blood circulation and lower blood viscosity.

    By the end of puberty, every young person should be examined by a urologist. If by this time there is no disease, then in the future the disease no longer threatens. A healthy lifestyle, proper nutrition, vitamins - necessary conditions to prevent pathology.

    It is necessary to dose loads, monitor weight, perform therapeutic exercises, conduct regular sex life.

    It is recommended to treat intestinal disorders in time to prevent stool retention and increased pressure. This significantly reduces the risk of developing pathology.

    Varicocele in adolescents - modern treatment methods

    Pathological expansion affects not only the blood vessels of the lower extremities, but also the veins of the spermatic cord. This form of varicose veins often occurs in the puberty, especially at the very beginning of puberty in a teenager. Without adequate therapy, the disease can lead to irreversible consequences.

    Varicocele - causes

    Urologists do not yet know exactly what provokes the described problem. The main factor causing varicose veins of the testis is considered heredity. If relatives have similar vascular disorders, flat feet or heart failure, the risk of developing the disease in the child increases significantly. Other suggested causes of varicocele in adolescents:

    • hormonal disorders in combination with venous wall insufficiency,
    • intense physical activity,
    • failures of metabolic processes,
    • overweight,
    • high blood pressure in the pelvic area.

    Varicocele - degrees

    Four stages of progression of the pathology under consideration were identified. At the zero or subclinical stage, the veins are slightly expanded.

    During this period, varicocele in children cannot be detected at a specialist examination, but altered blood vessels are noticeable during phlebography or ultrasound.

    The subclinical form of the disease is not accompanied by any symptoms, so it is extremely rarely diagnosed.

    Varicocele 2 degrees

    The moderate severity of varicose veins is more pronounced, damaged vessels are felt even without tension of the abdomen and increased abdominal pressure.

    This form of varicocele in adolescence is often diagnosed with planned preventive consultations with a specialist.

    Venous lumen at stage 2 of the disease is not yet greatly expanded, but the vascular walls are already prone to stretching. The boy may experience early symptoms of pathology.

    Varicocele 3 degrees

    The pronounced type of the disease is easy to notice with an independent examination. Damaged veins are clearly visible without medical equipment and laboratory tests. Adolescent varicocele in stage 3 is combined with testicular atrophy.

    Changes are often made to both sides of the scrotum, even if varicose expansion affects only one testicle (mainly on the left). Severe varicocele in adolescents is accompanied by clear clinical manifestations of the disease.

    • discomfort, feeling of heaviness while walking or standing,
    • scrotum pain
    • sinuous subcutaneous lesions in the testicular region,
    • swelling or swelling of the affected areas,
    • increased pain during physical exertion,
    • testicular asymmetry
    • decrease in volume and density of testicles.

    What is the danger of varicocele?

    There are suggestions that varicose veins in the testicles can provoke the extinction of their functions (sperm production) and atrophy.So far, only in adult men the relationship of infertility and varicocele has been proven - the consequences of the disease in adolescence have not been thoroughly studied.

    Difficulties in research are due to the difficulty in obtaining sperm in boys before final puberty.

    Even with biological material, it cannot be reliably evaluated by standard criteria, because physiological parameters in the puberty are too variable.

    How to identify varicocele?

    Confirm the described pathology in the early stages is difficult due to the lack of specific symptoms and visual manifestations of the disease. With the help of laboratory methods, it is also impossible to detect varicocele - the diagnosis of a blood test for hormones is not informative. Varicose veins in the scrotum rarely cause endocrine imbalance and this only occurs in the later stages.

    To determine the varicocele in adolescents, the following techniques are used:

      1. Sample Valsalva. The boy is asked to hold his breath and squeeze heavily. This method provokes an increase in intra-abdominal pressure and swelling of the dilated vessels.
      2. Ultrasound procedure. This technology provides a reliable assessment of the state of the veins and reflects the condition of the scrotum in 3 planes.
      3. Testiculometry. With the help of a special device (orchidimeter), the exact size of the testicles is determined.
      4. Dopplerography. Hardware research technique, reflecting the state of blood vessels, their walls.

    1. CT scan. This technology is rarely used, it is necessary to differentiate varicose veins from tumors in the retroperitoneal zone and vena cava thrombosis.
    2. Phlebography. The study is mainly used for adult men. To a teenager, it is assigned only with low information content of the previous options.

    How to treat varicocele?

    The complexity of the treatment of this problem in adolescent boys is the danger of subsequent relapses. During puberty, the filling of the veins and pressure inside the abdominal space constantly and dramatically changes, so it is better to postpone the treatment until the young man is 12 years old (if there are no specific symptoms of varicose veins).

    Many parents are interested in whether a varicocele can pass by itself in a teenager. Urologists answer this question in the negative, the described disease at any stage of development does not disappear.

    The only way to effectively combat it is the surgical removal of varicocele in adolescents - treatment without surgery has not yet been developed. Neither medicines nor folk recipes produce the proper therapeutic effect.

    Their independent use can lead to irreversible complications, including infertility.

    Varicocele in adolescents - operation

    Before the appointment of a surgical intervention, a thorough examination and conduct of hardware or instrumental diagnostics are performed.

    This helps to determine the degree and severity of varicocele in a teenager - whether the operation is decided solely by the urologist based on the results, subjective symptoms and the boy's age.

    If the patient is too young to perform the procedure, varicose veins are at an easy or first stage of progression, surgical therapy can be postponed. In such cases, they are limited to regular monitoring and monitoring of testicular condition.

    Modern surgical treatment of varicocele in adolescents is carried out in several ways:

    • laparoscopy,
    • Marmara’s method
    • endovascular intervention
    • Ivanissevich procedure.

    Varicocele - laparoscopic surgery

    The presented type of surgical intervention is minimally invasive. The procedure is performed under general anesthesia, but does not require long-term rehabilitation.

    After laparoscopic therapy for varicocele in adolescents, you can go home the very next day.

    The full recovery course is up to 4 weeks maximum, but most young patients require only 12-15 days. How is varicocele surgery in a teenager:

    1. The abdominal cavity is filled with carbon dioxide to facilitate access to the veins.
    2. A 10-millimeter tube (trocar) is installed in the navel area. A microscopic video camera is introduced through it.
    3. On the sides are inserted 5-millimeter trocars, which serve as "tunnels" for medical equipment.
    4. Special clips are applied to the dilated veins.
    5. The spermatic cord is sutured.
    6. Trocars are retrieved. The wounds from their introduction are sutured.

    Varicocele - operation Marmara

    This version of the procedure is considered the most painless, effective and safe. Microsurgical varicocelectomy has important advantages over other methods of varicocele repair - operation by Marmara rarely is associated with complications and recurrence (less than 4% of cases), injured tissue is minimal, does not need hospitalization. Course of the procedure:

    1. A small incision is made at the exit site of the spermatic cord under local anesthesia (up to 3 cm).
    2. Using a microscope or binocular magnifier, the doctor detects damaged veins and bandages them.
    3. The incision is sutured.

    What is varicocele of the 1st degree, the causes of the appearance of pathology

    Varicocele of the 1st degree is an ailment in which veins become visible due to a violation of blood supply in the area of ​​one of the testicles. More often the pathology is found on the left, but in recent years, cases of a bilateral problem have become not uncommon. The peculiarity of the pathology course is its negative effect on heat transfer. This leads to a local increase in one of the testicles.

    The first degree is the easiest. It does not cause discomfort or the development of pain. According to statistics, pathology occurs in all age groups, but is more often found in adolescents from the age of 14, when an active change in the hormonal background begins.

    Varicocele of the first degree is found in 10% of men who have been diagnosed with primary infertility and in 40-80% of those who have secondary infertility.

    Endovascular Surgery - Varicocele

    Another name for this surgical intervention is vein embolization. Such treatment of varicocele in children and adolescents is rarely prescribed due to the peculiarities of physical development and the width of the blood vessels. For the endovascular procedure, a large femoral vein is punctured. A flexible catheter is inserted through it, which in turn penetrates the following vessels:

    • lower hollow Vienna,
    • Renal Vienna,
    • the mouth of the veins testicle.

    All manipulation is done under the control of X-ray machine. When medical equipment reaches its goal, blood flow is blocked (embolization) by installing a special plug.

    This treatment option is more suitable for controlling varicocele in adults and adolescents older than 16-17 years. At the indicated age, the width of the blood vessels corresponds to the size of the surgical catheter.

    Varicocele - complications

    Very rarely presented surgical options are combined with negative consequences:

    • hydrocele (hydrocele)
    • hematoma,
    • bacterial infection,
    • damage to the artery and vas deferens,
    • testicular atrophy,
    • chronic pain,
    • thrombophlebitis
    • bleeding and others.

    The main danger after surgical treatment of varicocele is relapse. The probability of its occurrence depends on the chosen method of surgical intervention. The most preferred embodiments:

    • Marmara operation
    • vein embolization,
    • laparoscopic ligation.

    Watch the video: Tonsils and Adenoids Surgery (March 2020).

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