varicocele It is a vasodilatation that occurs in the veins of the testicles (ovaries). It may progress with age and cause sperm production disorders. In very advanced cases, it may cause a decrease in testicular size and disorders in testosterone production.
The temperature in the bags called scrotum is 2-3 degrees lower than the body temperature. Increased heat as a result of blood pooling around the ovaries negatively affects sperm production and disrupts reproductive function. Increased vascular structure and blood supply affects the functions of the testicle and may lead to the accumulation of harmful waste from the kidney and adrenal glands. It causes sperm production to stop at a certain level or sperm motility and structure to deteriorate.
frequency of occurrence
Varicocele was detected in 25% of men with defective sperm test and in 12% of men with normal sperm parameters. Additionally, 35-40% of men complaining of infertility have varicocele.
It is mostly seen on the left side. The veins on the left side are longer and the blood cannot drain completely because they are connected at a right angle to the main vein from which the blood flows. Sometimes it can occur bilaterally or rarely only on the right side.
How is it diagnosed?
The most important diagnostic method is physical examination. Diagnosis is made by manual examination of the vascular and nerve structure leading to the testicle. During the examination, intra-abdominal pressure is increased by coughing or straining and the dilated vascular structure is recognized.
Varicocele research can be done with Doppler ultrasound, but it has been reported that varicocele detected only by ultrasound has no clinical significance and there is no need for surgery.
treatment
The treatment is surgery, the vessels are connected with an operation performed in the groin area under the guidance of a microscope. Using a microscope in surgery allows the vessels to be identified more clearly and the vessel feeding the testicle to be carefully protected.
varicocele can be treated using microsurgical methods; It is the most common cause of male infertility. In varicocele cases diagnosed correctly and treated with the successful application of microsurgical methods, a 60-70% improvement is achieved in spermiogram values. However, there are conflicting studies about the extent to which this improvement in sperm improves pregnancy rates.
Generally, cases who cannot become pregnant despite the improvement in spermiogram results within 6 months following the varicocele operation must definitely proceed with intrauterine insemination (IUI) or in vitro fertilization (microinjection). In mild but not extreme sperm disorders, sperm washing process and by vaccination It is possible to achieve pregnancy. If necessary, the opinion of a Urologist is taken. In severe sperm disorders, insemination cannot be beneficial and in vitro fertilization is not recommended.microinjection treatment must be applied.
If there is no sperm in the sperm sample given and if the reason for this is not detected as a blockage, that is, if there is a lack of sperm production, then the sperm obtained from the pieces taken from the testicles (man's ovaries) is used (TESE). in vitro fertilization treatment It is necessary to do.