It is rarely known that fifteen to twenty percent of all males do suffer from some form of a disorder called varicocele, which affects their fertility. And most of these patients are shy of visiting the doctor to disclose this illness except when they are under severe pain. The disorder occurs in the scrotum, the part of a male's body located behind the penis. In medical language, it is called Varicocele, which is caused by an abnormal enlargement of the Pampiniform Venous Plexus of the scrotum. The disorder is caused by defective valves or compression of the veins. It can cause dilatation of the testicular veins near the testis, leading to the formation of a varicocele. The disorder may cause dragging like or aching pain within the scrotum, feeling of heaviness in the testicle(s), atrophy or shrinking of the testicle(s) low testosterone, infertility or enlarged vein. The disorder is similar to what happens when one suffers from varicose veins, which commonly occurs in our legs. This results in the backflow of blood. In varicocele, the backflow leads to permanent damage to the testicular tissue due to disruption of normal supply of oxygenated blood through the testicular artery. The disorder develops slowly and may not have any symptoms. It is most frequently diagnosed when a person is between 15 and 30 years of age. It rarely develops after the age of 40. Fifteen to twenty percent of all males suffer from the disorder, and as mentioned earlier, they are shy of disclosing it. Ninety-eight percent of the varicoceles without specific causes occur on the left side apparently because the left testicular vein connects to the renal vein at a 90 degree angle, while the right testicular vein drains at a lesser angle. The varicocele disorder is treated either by open surgery or a non-surgical procedure called Varicocele Embolization. Mostly those who have a discrepancy in testicular size or marked semen abnormalities undergo the treatment. According to a recent analysis one in seven men treated could obtain pregnancy. Till recently, surgery was the only option, but thanks to the recent advancement in medicine, a minimally invasive technique, called Varicocele Embolization is available. The new technique can be performed painlessly in an outpatient setting. The new technique uses coils to block blood flow to the dilated vessels in a varicocele. The Endovascular specialist places a catheter in the affected vessel and then deploys the coil in the targeted area. Under the new procedure, which is performed in an outpatient setting, the patient needs stay in the hospital for about three hours and can go back to work in 24 hours. They have mild discomfort for only three days. The new procedure has achieved, according to a recent estimate, 95 percent success and needed no further intervention. Even today, a majority of patients in India undergo surgery, as many do not know about the Varicocele embolization. The new procedure is as effective as surgery, which has been measured by improvement in pain, semen analysis and pregnancy rates. It does not require any surgical incision in the scrotal area. Also a patient with varicoceles on both sides can have the disorder fixed at the same time through one vein puncture and the procedure does not require a general anesthesia to be administered before a patient undergoes it.
Dr Sheorain is a Specialist in Vascular Surgery in Medanta Hospital Gurgaon, and has been performing Varicocele Embolization for 10 years.