Varicoceles are essentially varicose veins leading to the testicles. These inflamed veins are a fairly typical condition among males and as many as 20 percent of all males have varicoceles and up to 40 percent of infertile males have a varicocele.
Science hasn’t yet clearly determined why men get varicoceles but the condition, itself, is quite well understood.
The veins that drain the testicles are built with valves which prevent backflow of blood. When these valves become damaged or defective, blood begins to pool in the area, causing an increase in temperature, inflammation and tortuosity. The feeling of having a varicocele has often been described as feeling like there is a bag of worms near the testicle of the afflicted side. In fact, you can feel this with your hand. It feels like a twisted, tender mass leading to the testes. The pain associated with varicocele ranges from nothing at all to rather severe pain. Many men are completely asymptomatic.
The great majority of varicoceles are found on the left side of the body. The reason for this is because the left gonadal vein drains the left renal vein at a 90 degree angle but the right renal vein drains directly into the vena cava.
Varicoceles that occur on the right side are unusual and should prompt examination of the abdomen with ultrasound to determine whether or not a mass is present and causing the venous compression. While this is certainly a concern, a recent study concluded that most varicoceles are, in fact, bilateral. That is, they are present on both sides and often missed by ultrasound.
Varicocele diagnosis usually requires an examination by a doctor who feels the testicles and nearby areas. When a varicocele is uncovered, it’s a good idea to back up the diagnosis with an ultrasound procedure. Since this is the most reliable and least invasive way to diagnose this condition, it is the best option. Also, in contrast with a CT scan or x-ray, ultrasound scans do not emit any radiation and are safe for prolonged use. But since even the most trained ultrasound techs can fail to find a varicocele, it’s a good idea to insist on performing the scan on the color-flow Doppler setting.
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