Patient's question:
Symptom Description: Occasional soreness and fullness in the scrotum, onset time between February and March.Treatment History and Effect: Currently undergoing conservative treatment with the medication Matislin tablets.
Help Needed: Is this condition serious? What precautions should be taken daily? Can normal sexual activity be performed?
Doctor's answer:
Hello, varicocele refers to the dilatation and tortuosity of veins in the spermatic cord due to impaired venous return. It is a common disease among young and middle-aged adults, characterized by the dilatation, tortuosity, and elongation of the pampiniform plexus (veinary plexus) caused by venous stasis in the spermatic cord. The incidence rate in the male population is 10-15%, accounting for 15-20% of male infertility cases. 90% of this condition occurs on the left side.During examination, the patient is asked to stand. The affected scrotum is visibly lower, and sometimes curved veins can be seen on the skin surface. The veins in the scrotum form a tangled cluster, and a urological examination may reveal tortuous and dilated veins resembling earthworms. The complications of varicocele can affect fertility and may lead to testicular atrophy in severe cases.
Causes: The temperature in the affected scrotum rises and reflects to the opposite side, causing degeneration, atrophy, and a reduction in sperm count. Alternatively, serotonin or steroids secreted by the left adrenal gland may reflux into the testes through the left spermatic vein, leading to a decrease in sperm count.
If diagnosed, it is recommended to seek medical attention promptly to avoid fertility issues. Mild varicocele may be asymptomatic. However, moderate to severe varicocele can cause a sensation of heaviness, swelling, and pain in the testicles. The dilated veins may be visible or palpable. If a visibly earthworm-like varicocele is present, immediate medical treatment is necessary.