• In which cases it is advisable to intervene with a varicocele operation
  • The most common symptoms of varicocele
  • The three degrees of varicocele
  • Possible triggering causes
  • When and how to perform a varicocele operation

In which cases it is appropriate to intervene with an operation for varicocele 2nd
degree varicocele, 3rd degree varicocele
what it is What
this pathology entails and what are the
consequences of the different degrees of the pathology
Let’s try to
clarify, explaining, first of all, what it is.
is a disease that affects the
system of the testicle : there is a dilation of
or veins that drain blood from the
testicle, thus causing a reflux of
that brings out a single vein
called the internal spermatic vein .
In most
cases affected by varicocele
and the left testicle.
The most common symptoms of varicocele
The disease occurs
in pubertal age, between 11 and 16 years, but often the man does not
notice anything due to the absence of symptoms. The problem
arises when it is difficult to conceive and undergoes
a specialist examination to ascertain infertility or sterility .
In other cases the
presence of the pathology is evident, the varicocele
in the picture

or simply by sight is easily recognizable.

  • Dilated veins resemble varicose veins , appear
    a mass and can be palpated inside
    the scrotal bag, even if this pathology is almost
    always asymptomatic .
  • In cases where pain occurs it is felt more
    as a nuisance or as a burden and these symptoms
    of varicocele

    occur mostly when
    practicing sports.
  • Sometimes there may be pains or cramps that
    disappear spontaneously, in other cases the pain persists and
    since there are no drugs capable of definitively solving the problem, a
    is often necessary .

The three degrees of varicocele Varicocele
has different degrees

of importance which are classified according to the different type
of severity level of the problem. The
third degree
varicocele is
the most evident one, which necessarily requires
surgical intervention with a
operation .
The intervention of the doctor who performs an andrological examination is essential to define the degree of the pathology. In the pre-clinical phase, varicocele appears as a bluish spot in the upper part of the scrotum.

  • In the first degree it is palpable only with the
    Valsalva maneuver
  • In the second degree, reflux is palpable (it increases with
    the Valsalva maneuver).
  • The third degree varicocele is
    palpable and evident even at rest.

An ultrasound of the abdomen, pelvis, and
testicles is helpful in measuring the size of the varicocele. During the
ultrasound, an echo-color Doppler is also performed, useful for understanding the
speed of venous flows both during maneuvers and at rest.
Before a
operation , however
, the clinical grade and the ultrasound grade must always be performed. Possible triggering causes
The causes of varicocele in the testiclethey are still being studied, but it would seem that tall stature and overweight may be elements capable of increasing the risk of the onset of the disease. When and how a varicocele operation is performed Varicocele is
most frequent cause of
subfertility : over time, blood stasis can lead
to progressive damage to the testicular parenchyma and an
increase in the temperature of the testicles. This damage
is measurable with the spermiogram .
However, it is possible that the presence of varicocele is not
necessarily accompanied by an alteration in fertility: in this case
it should not be treated, immediately tooperating
level , but only monitored over time.
The purpose of a
operation is to preserve the
patient’s fertility
: it consists
in ligating or occluding the roots of the spermatic vein in order to
block its venous reflux.
The internal spermatic vein can be occluded
with a sclerotherapy
, that is an
embolization that does not need surgery, or
through a
ligation operation .
Current evidence indicates that subinguinal microsurgical ligation
of the spermatic veins
the most effective method among the various varicocelectomy techniques.
Microsurgical repair is the gold standard for the
highest success rate, the fewest complications.
However, it is always advisable to consult a specialist doctor to evaluate how to proceed. It should be remembered that according to international guidelines regarding varicocele operation , after the age of 35 the prognosis of the operation drops drastically.

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