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When performing a paraclinical examination, through ultrasound, the doctor will conclude that the patient has varicocele if the diameter of the spermatic vein is larger than 2.5 mm.1. When is varicocele?
Varicocele is a condition of the plexus of the spermatic cord and the internal spermatic cord. This is one of the causes of impaired testicular function, reduced reproductive function, making nearly 40% of cases with a high probability of infertility.
Up to now, it is still not possible to conclude the direct cause of this male pathology. Studies have put forth many hypothetical causes such as venous insufficiency, abnormal emptying of the seminal and left renal veins or the abdominal vena cava, the causes of increased intra-abdominal pressure...
In addition to the clinical diagnosis, the examination doctor will easily recognize the varicocele when the patient is lying down or sitting, and palpating the varicose veins will be detected. When performing a paraclinical examination, through ultrasound, the doctor will conclude that the patient has varicocele if the diameter of the spermatic vein is larger than 2.5 mm. Based on that, the patient will have 5 degrees of dilation:
Varicose veins grade 1: No varicocele in the scrotum, appearance of thoracic flow of the spermatic vein plexus in the spermatic cord, the inguinal canal when Perform the Valsava maneuver Grade 2 varicocele: No dilation in the supine position, dilation in the supine position, and localized reflux in the upper pole of the testicle Grade 3 varicocele: No dilatation in the supine position. , standing posture has dilation and reflux flow to both upper and lower poles of testes Grade 4 varicocele: Dilatation and reflux when performing the Valsava maneuver in the lying position Grade varicocele 5: Dilated, with reflux even without additional Valsava maneuvers.
2. Surgical treatment of varicocele is the most effective
Surgery is considered the most effective method to treat varicocele in men. By surgery, the entire system of varicose veins can be treated. In addition, it also preserves the internal seminal artery and the vas deferens artery, preserving the intact vas deferens, lymphatics... for patients. The surgical methods of varicose veins are being applied treatment at present, patients can be consulted by doctors such as:
Laparoscopic surgery to ligation of the internal spermatic cord. Interventional occlusion. Ligation of the retroperitoneal internal seminal vein by open surgery. Traditional surgery through the groin, scrotum. Microsurgery of the inguinal tract. Each surgical method has its own advantages and disadvantages. For example, the cost of interventional embolization is quite high, while vasectomy has a recurrence rate of 7 - 33% in adults and 15 - 45% in children. For inguinal microsurgery with the highest treatment results, the recurrence rate is very rare
However, depending on the specific condition of each patient, the specific degree of dilation in each patient, the specialist doctor The department will have the most effective advice and indications for patients with varicocele.
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