In modern medicine, phlebological diseases in males are often diagnosed. One of them is the varicocele, the stages of development of which will be presented below. This pathology is an expansion of the veins in the testicles and spermatic cord. Usually such a disease is observed in sixteen-year-olds, it often leads to infertility. According to statistics, pathology is diagnosed in 16% of men worldwide, in 90% of cases it leads to a disorder of spermatogenesis.
Description and description of the problem
Varicocele, on the stage of development of which the method of therapy will depend, is a varicose testicle, forming plexuses in the form of a bunch of grapes.
The disease develops as a result of impaired valve activity in the veins, therefore, there is a violation of the reverse outflow of blood. Pathology is accompanied by pain, discomfort and a feeling of heaviness in the scrotum. In some cases, there is a rupture of blood vessels and hemorrhage in the scrotum, as well as an inflammatory process. In the absence of therapy, the disease progresses and leads to a decrease in the size of the testicle, the development of infertility.
The initial stage of varicocele does not pose a threat to the patient's life and does not bring him any special problems. In advanced cases, complications and negative consequences develop. Often the pathology proceeds without the manifestation of signs, so men do not go to the doctor, which aggravates the situation. In most cases, the left testicle is affected, since it differs in the anatomical development of the venous system.
The disease provokes the development of infertility, which is characterized by the presence of three factors: a decrease in the number of spermatozoa, their inferiority, impaired mobility and outward discharge. Varicocele contributes to dysfunction of the testicles, an increase in their internal temperature, which leads to damage to the seed.
Causes of the disease
The stages of varicocele in the photo can be found in medical institutions on special stands along with information about the pathology. Doctors say that the cause of the disease is an increase in pressure in the veins as a result of their special anatomical location.
Provoking factors include:
- strong power loads for a long period of time;
- diseases of the vascular system leading to an increase in blood pressure;
- thrombosis;
- insufficiency of connective tissue, which is lined with venous walls;
- congenital malformation of the inferior vena cava;
- venous hypotension;
- increase in intra-abdominal pressure with constipation;
- the body is in an upright position for a long period of time;
- prolonged pressure on the veins of the kidneys.
Varicocele in men: stages of development
The disease goes through several stages of development. Usually it manifests itself in adolescence, reaches a certain degree of development and is no longer exacerbated. The transition from one degree to another is rare.
The following degrees of pathology are distinguished:
- Varicocele stage 1 is asymptomatic, pathology is usually detected by ultrasound or dopplerography. There are no visible changes, sometimes the patient may feel heaviness in the testicle.
- Varicocele stage 2 shows signs in a standing position or after prolonged physical exertion. In this case, you can feel the expanded veins.
- Varicocele stage 3 is characterized by expansion of veins, which can be found in any position of the body. The symptomatology of the pathology begins to bring discomfort to the person.
- Varicocele stage 4 is characterized by pronounced symptoms. With a visual examination, you can find expansion of the veins. At this stage, pathology often leads to the development of infertility.
Symptoms and signs of the disease
The initial period of the development of the disease is asymptomatic. At the first stage of varicocele, it is not possible to identify the disease, therefore, men do not go to a medical institution, it can be detected during a preventive examination.
As the disease progresses, pain appears in the testicle, scrotum, groin area. The scrotum may be omitted or enlarged on one side, usually the left. Such manifestations are possible in the second stage of varicocele. In some cases, there may be discomfort when walking, increased sweating, burning in the scrotum. Sometimes a visual examination reveals a prolapse of the testicle, sagging half of the scrotum.
At the last stages of varicocele, the connection between power loads and pain disappears. The pain is permanent. Upon examination, the doctor reveals a large number of veins resembling clusters of grapes. The testicle and half of the scrotum are still growing. Asymmetry becomes pronounced. In some cases, the pathology takes a chronic form.
Diagnostic measures
The examination is carried out by a phlebologist. Diagnosis is usually not difficult. First, the doctor studies the history of the disease, conducts a survey and examination of the patient to determine the prescription of the pathology and the reasons for its development. Particular attention is paid to the presence of injuries in the lumbar region.
Depending on the stage of varicocele, the doctor may, with a visual examination, find nodes of a spherical shape. Veins on palpation will be sinuous, soft. In some cases, the affected testicle becomes flabby and reduced in size. Palpation is carried out in the vertical and horizontal position of the body, also perform a Valsalva test. Then the doctor prescribes the following diagnostic methods:
- laboratory tests of blood and urine;
- Ultrasound of the kidneys, scrotum and the space behind the peritoneum;
- MRI, CT to detect thrombosis and other vascular pathologies;
- spermogram is prescribed to patients who are eighteen years old;
- dopplerography, thermography and thermography;
- renal egg and antegrade venography;
- transcrotal testiculophlebography.
Also, in the presence of infertility, the doctor prescribes a study such as an MAP test to exclude the immunological factor of pathology, in which antisperm antibodies are formed in the male body that interfere with the conception of the child.
As additional diagnostic methods use:
- MIS analysis to study the morphology of male germ cells;
- HBA test to assess sperm maturity;
- the study of DNA of gametes for damage.
There can be many reasons for the development of pathology, therefore it is important to identify all the existing disorders that affect the formation of pathology. Photos of the stages of varicocele can be found in the office of a urologist or phlebologist.
Among the causes may be inflammation, hormonal and genetic disorders, addictions, malnutrition and many others.
Pathology therapy
If the cause of the pathology is vascular disease, then the underlying disease is treated. Surgical intervention in the first and second stages of varicocele is not resorted to. In this case, they use techniques that help eliminate stagnant processes in the pelvis. Patients are advised to exclude excessive physical exertion, to treat chronic constipation. Patients of advanced age are prescribed to wear a suspension.
Also, massage of the testicles in a horizontal position of the body is prescribed, physical exercises, in which you need to lower and rise on your toes, do inclinations several times a day. The use of antioxidants, amino acids to normalize sperm motility and improve sperm quality.
Every six months, it is required to be examined by a doctor. For six months, the patient should take antioxidants. If there is a positive result, the doctor can extend the treatment for one year. If therapy is ineffective, after six months, the doctor recommends using methods of additional reproduction, for example, IVF.
Surgical intervention
At the last stages of the development of pathology, surgery is performed. Indications for surgery are:
- severe pain and discomfort;
- oligospermia;
- impaired development of the affected testicle during puberty;
- cosmetic defect.
In surgery, several methods of surgical intervention are used for this disease:
- An operation according to Ivanissevich, in which a ligation or removal of a pathological vein is performed. To do this, an incision is made about five centimeters in size in the area of the entrance or exit of the inguinal canal, through which the vein is removed.
- An endoscopic operation, during which three punctures are performed in the abdomen, an endoscope is inserted through one, and the affected vein is ligated. The duration of such an operation is fifteen minutes.
- Sclerosis of the veins. In this case, a vein puncture is performed, where a catheter is inserted, a sclerosing substance enters through it, which stops the blood flow. Instead of this substance, a small spiral of metal can be installed, which will act as a “cork”. This operation is performed on an outpatient basis, the patient can go home on the same day. Such surgery has several advantages: it does not involve an incision and a suture, it is performed under local anesthesia, there is a low risk of relapse, and treatment in an outpatient clinic.
- Microsurgery or laparoscopy, in which veins are ligated. Reducing the risk of relapse. These techniques help preserve the integrity of the seminal artery and reproductive function.
- Bypass surgery involves the introduction of a shunt into the affected testicle, through which the outflow of blood is carried out.
- Laser surgery is also used frequently. This method of therapy makes it possible to eliminate the pathology under local anesthesia. In this case, blood loss does not occur during surgery, the risk of tissue injury is minimal, the recovery period passes quickly enough, there is no scar left in the healing process, and the possibility of developing coagulation necrosis is reduced to zero, the patient does not experience discomfort.
Such surgical interventions are performed without loss of blood, which contributes to the rapid recovery of the patient.
After surgery, one month is required for rehabilitation. During this period, it is recommended to avoid sexual intercourse, to exclude physical activity, the use of salty, spicy foods. After the surgery, the genitals return to normal, the bunch of veins disappears. After six months, patients undergo normalization of reproductive activity, so it is possible to conceive a child.
Complications and consequences
Complications may appear at every stage of the disease. In medicine, two groups of complications are distinguished:
- The first and second degrees of severity of the pathology. If surgery is ineffective due to the negligence of the surgeon, the risk of relapse increases. To prevent this, it is necessary to palpate the testicle before surgery and pass all the necessary tests. Of course, operations in the early stages of the disease are carried out infrequently, but the use of such a method of therapy is not excluded.
- The third and fourth stage of the disease can lead to the development of infertility, if the therapy was ineffective or was carried out untimely. Often at these stages, testicular atrophy occurs due to impaired outflow of blood to it and spermatic cord.
Forecast
Good results are achieved with the timely elimination of congestion in the pelvic organs. The prognosis will be good if patients follow the doctor's recommendations: to limit power loads, normalize the activity of the digestive tract, lead a healthy lifestyle and regular sex life with a regular partner, eliminate addictions, normalize the regime of rest and work.
Prevention
Preventive measures should be followed at any age. In children, the pathology can be congenital or acquired, mainly the first degree of the disease is diagnosed. In childhood, the disease is treated with medication. At the age of twenty, it is recommended that each representative of the stronger sex undergo an examination by a urologist. If varicocele at this age is not detected, then the disease will not develop in the future. It is important to remember the right lifestyle, moderate power loads, the use of vitamins and minerals. All this is a prevention of testicular varices and spermatic cord.
Thus, varicocele is a common pathology among males, which often leads to the development of infertility. With timely and effective treatment, this problem can be fully resolved, a person will be able to conceive a child. In severe cases, the disease leads to negative consequences. It is important to comply with all the appointments and recommendations of the doctor, then the pathology can be eliminated, and the risk of relapse is minimized.