Patient's question:
Hello doctor, during my pre-marital physical examination, I was found to have varicocele. The doctor said that if it's severe, it might cause infertility and needs to be treated as soon as possible. After hearing this, I felt very panicked and didn't know what to do.Doctor's answer:
Hello, varicocele refers to the dilatation and tortuosity of veins in the spermatic cord due to impaired venous return. Patients with varicocele may be completely asymptomatic and only discovered during physical examination. The affected scrotum or testis may have a sense of fullness or, with scrotal enlargement. When standing, the affected scrotum and testis are lower than the healthy side. Expanded and tortuous veins can be seen on the surface of the scrotum. A soft, earthworm-like mass can be felt upon palpation, and symptoms may alleviate or disappear when lying down. Patients may also experience neurotic symptoms such as headaches, fatigue, and hyperesthesia. Some patients may have sexual dysfunction, and varicocele can sometimes affect fertility. The left spermatic vein is longer and enters the renal vein at a right angle, resulting in some resistance to blood flow. The left spermatic vein near the left renal vein lacks valves, making it easier for blood to flow backward. Young and middle-aged adults often have more active sexual functions and abundant blood supply to the contents of the scrotum. Additionally, prolonged standing increases abdominal pressure, which is another contributing factor. In severe cases, it may lead to testicular atrophy. It is recommended to seek medical attention promptly for diagnosis and treatment.