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Varicose veins can cause infertility in men because it causes reduced sperm motility along with other problems such as sperm deformation, decreased testicle size, low sperm count. High maturity affects male fertility.1. How many levels of varicocele?
Varicocele is a dilation of the vas deferens including the internal seminal veins, the posterior seminal veins, and the scrotal veins in men. Most men with varicocele do not have any specific signs or symptoms that characterize the disease.
In the early stages, patients have no clinical symptoms, most of them are discovered because they go to the infertility clinic and then accidentally know the condition of the vas deferens. At the late stage, the patient will have a clinical manifestation of testicular pain, and when touching, you will feel the varicose veins dilated in the scrotum. Patients can easily notice the change when lying down.
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2. How many levels of varicocele?
Based on clinical symptoms to determine the stage of the disease. Varicose veins can be divided into 5 levels:
Grade 0 varicocele: no clinical manifestations, only detected by ultrasound, angiography and other subclinical diagnostic methods other. Varicose veins grade 1 : the patient feels the varicose veins on their own when doing the Valsava maneuver Grade 2 varicoceles are palpable when the patient stands upright Grade 3 varicocele : visible Visible varicose veins in the upright position Grade 4 varicocele: easily see clearly the varicose veins zigzagging under the scrotal skin even when the patient is standing or lying down. On subclinical examination by ultrasound, when the diameter of the spermatic vein is > 2.5mm, it is diagnosed as dilated, often combined with the Valsava maneuver to evaluate. Then, varicocele is divided into 5 levels:
Varicose veins grade 1 : no varicocele in the scrotum, thoracic outlet of the spermatic vein plexus occurs in the spermatic cord, inguinal canal when doing the Valsava maneuver Grade 2 varicocele: no dilation In the lying position, there is dilation in the supine position and the reflux is localized in the upper pole of the testicle. Grade 3 varicocele: no dilation in the lying position, in the standing position, there is dilation and the reflux is diffuse to the whole pole. superior and inferior testicular varicocele Grade 4: dilated and regurgitated when performing the Valsava maneuver in the supine position Grade 5 varicocele: dilated and regurgitated even without additional work the Valsava maneuver.
3. Causes of varicocele causing infertility
Experts say there can be 4 reasons to explain varicocele causing infertility. That is:
The temperature in the testicles increases for a long time, causing the sperm production here to decrease. Venous stasis in the testicles is because the metabolic products in the testicles are stagnant, and the elimination from the testicles is slow. The blood supply to the testicles is reduced because of venous stasis, the arteries to the testicles are significantly reduced, so oxygen and nutrients feeding the testicles are reduced. Affects spermatogenesis Hormone disorders in the testes directly affect the axis of the hippocampus, pituitary gland, and testes, causing gonadotropic hormones to be disrupted, adversely affecting sperm production. complete. All of the above reasons are the reasons for infertility in men with varicocele.
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4. How to treat varicose veins?
Previously, surgery was considered the most effective treatment for varicocele. Men with varicocele are indicated for surgery to have normal fertility. Patients will be surgically ligated by laparoscopic or open surgery.
Up to now, with the advancement of interventional radiology, endovascular treatment of varicose veins by endovascular intervention is more effective, popular and gradually replacing surgical treatment. With this method of treatment, the patient does not need surgery, no anesthesia or spinal anesthesia, no scarring and especially no risk of vasectomy.
Endovascular interventional treatment method brings outstanding advantages for patients with varicocele such as:
No incision in the scrotum and groin No damage to the vas deferens. Treatment effect is equivalent to surgery. Surgery Short hospital stay is usually less than 24 hours Just general femoral vein anaesthesia, no need for general or spinal anesthesia However, currently the cost of this treatment is higher than surgery and has may be exposed to X-rays during the intervention.
Patients with varicocele need to be examined and receive treatment advice from a specialist in order to best suit their situation and bring maximum effectiveness.
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