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Scrotal Varicocele Problem

Scrotal Varicocele Problem

Varicocele is the dilatation of the network of many small veins found in the male spermatic cord around the testis. It is the most frequently encountered mass of the spermatic cord.

How common is varicocele?

The estimated incidence is at ~15% of the general male population and ~40% of sub fertile and infertile men. It is more common cause in men when trying for the second baby.

How is varicocele diagnosed?

Varicoceles can be asymptomatic. If symptomatic, men may present with scrotal mass/swelling, scrotal pain- constant dragging pain and low sperm parameters.

How varicocele causes male subfertility?

The network of many small veins found in the male spermatic cord around the testisnormally act as heat exchangers, important in the thermoregulation of the testes which is vital for spermatogenesis. A varicocele disturbs this balance and causes heating up of the testis to the normal core body temperature and affects sperm parameters.

What are the types of varicocele?

A varicocele can be classified as primary or secondary.

Primary varicocele: Most varicoceles are primary and result from incompetent or congenitally-absent valves in the testicular vein. The left testicle is affected much more commonly than the right. Bilateral varicoceles are not uncommon, but isolated right varicocele is rare and should prompt evaluation for a secondary varicocele.

Secondary varicocele: Secondary varicoceles are much less common and result from some pathology or abnormality.

How does scan help in diagnosing varicocele?

Ultrasound is the diagnostic modality of choice. In ultrasound, we can see:

  • dilatation of pampiniform plexusveins >2-3 mm in diameter 
  • characteristically have a serpiginousappearance
  • there can be flow reversal with the Valsalvamaneuver
  • Doppler ultrasound can be used to grade the degree of reflux

Treatment and prognosis

This is among one of the surgically-correctable causes of male infertility. Management options include:

  • Embolization of the testicular vein
  • Surgical – Varicocele ligation of the testicular vein

Varicocele Ligation: Selection of cases for varicocele ligation is important to expect improvement following surgery. Young age couple, shorter duration of infertility, not severe oligospermia, grade 2 and grade 3 varicocele and normal female factors will ideally improve sperm parameters following surgery.

 If the varicocele is of significant size (Grade II or Grade III), about two thirds of men undergoing the surgery will see some improvement in sperm quality. The reported pregnancy rates following surgery are in the range of 40%, but most pregnancies occur 6-9 months following surgery. The age of the female partner needs to be a major consideration.

Improvements in the semen parameters are seen approximately in 40-50% of patients after varicocele surgery. This may take 3-6 months after surgery to see improvements in semen parameters.

If the initial sperm count and sperm motility are in the severe male factor infertility category, the couple might have to consider other options such as sperm retrieval and IVF / ICSI.

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What Our Client Say

We love that our patients feel inspired to write about the care they received here at Vishvas Fertility! Here are some of the wonderful letters and comments we have recently received.

pramod kr
pramod kr
2023-11-07
We visited Dr. Basavaraj for our treatment. We had to visit for over an year and couple of procedures. Doctor is very knowledgeable and has vast experience. Nurses and other lab staff are good. Initially the wait time was less ,however off kate the wait time is on higher side since doctor does scan and procedures in parallel. The wait time doesn't change even with prior appointment . This is especially true in Marathahalli centre. This can be improved. I feel cost here for treatment is much lesser than any corporate hospitals or other centres. Doctor is mostly straight forward and not verbose. Also doctor prescribes just enough medication which might or might not be good, hard to judge.
Rajeev Kothamachu
Rajeev Kothamachu
2020-11-12
I highly recommend the doctor if there any complications. I visited him and we got very good results. He has very good patience and listen all the problems. Doc is not that commercial he is collecting the same from last 4 years. We are now visiting him again for 2nd pregnancy..
Divya Sharma
Divya Sharma
2020-09-08
Dr Basavaraj is amazing and genuine person. Report asked by him are only needed one, no additional like many other place. All clinic staff are even good n helpful, Appointment recommended Over all very good Dr for fertility.
Vinay K
Vinay K
2019-05-16
Very good doctor , provides good information about the procedures ,
Abhijit Sarkar
Abhijit Sarkar
2019-05-14
We worship God and many says that Doctors are possibly the one. We (me and my wife) evident that in our difficult time. Thank you Dr. Basavraj for your treatment and care. You will always be there in our heart and any word of gratitude is not enough. We have blessed with a baby boy and he is doing great. we were struggling from almost 3 years and finally we have been blessed. We (me and my wife) can never forgot what you did for us. When in difficult time people goes away, you have been our hope and belief. we were really very lucky enough that we got a chance to meet you in person and got the treatment. Our Best wishes to you Doctor and may you help many more people who are suffering from fertility issues. We were really amazed that even after such a busy schedule doctor finds the time to respond whenever it was required (in panic situations). Thank you once again doctor for your personal attention. Our best wishes for you and your family. We will surely come and meet you very soon, I am sure my son also will be blessed by just seeing you. You have given us the reason to Smile 🙂
Bharath Konegadde
Bharath Konegadde
2019-05-06
Dr Basavaraj Shetty take care and advice till 3 months pregnancy . One of the best doctor in hsr
Dr Chetan Kumar N.G
Dr Chetan Kumar N.G
2019-04-16
Dr Devarshetty has a midas touch in his treatment apart from his knowledge skills as a infertility specialist. I recommend all patients to be open minded while consulting him. My wife had a very difficult phase in conceiving after getting ectopic pregnancy twice in 2015-16 because of her PCOD . Being a Dr myself i couldn't cope up with the stress with which i and my wife underwent during those times,later in 2016-17 after Dr Devarshetty advise and treatment we finally became parents and it was the most joyous moment of our married life. Now we have a healthy baby girl 10m old..posted mother and baby image.

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