Varicocele - diagnosis, treatment, postoperative period

To prevent the development of varicocele, possible negative consequences of the disease, a man should periodically visit a urologist, at least once every couple of years, just as a woman goes to a gynecologist for examinations. By doing this, he protects not only himself and his health, but also women's health.

Diagnostics and examination

Checking for varicocele is included in the standard of a urologist, he is obliged to examine the scrotum. The initial examination is performed standing and lying down. In these positions, the doctor carries out an individual assessment of the man's condition; each specialist diagnoses the disease differently, someone can say that there is a varicocele, and someone cannot. If there is any suspicion of varicocele, if the patient presents any complaints, then the doctor prescribes an ultrasound of the scrotum with Dopplerography in order to see how the blood flow is going there.

There is a Valsalva test: when the width of the veins changes during straining, it can be measured. Normally, the width of the vein is up to 20 mm, then changes are observed.

Then the patient's condition is clarified: if there is pain, then this is a direct symptom of varicocele and an indication for surgery. Pain can be temporarily relieved with pills, but constantly taking pills is difficult and ineffective, and there is no point in it. If there is no pain, then it is necessary to do a spermogram. If the spermogram is good, then everything ends there, and the patient is transferred to dynamic observation. If there are changes in the spermogram, then this is also an indication for surgical treatment. You should not leave the cause of such changes, it is better to remove it and monitor the patient's recovery.

Every urologist has patients with varicocele in their practice who do not undergo surgery and go for 2-3-5 years, sometimes coming for check-ups. They usually do not have any dynamic changes, they have ultrasound results for previous years or already remember all the numbers. When the ultrasound doctor says that there are no changes, then the patient is simply periodically observed. If there is a negative trend, then it is better not to wait for the destruction and suppression of testicular function and undergo surgery.

There are about a hundred methods of performing surgery, but no one will give a 100% guarantee of success, since each method has a certain risk of relapse of the disease. If there are changes and a painful condition, then you should not run away from surgery, because in this case it is necessary either to constantly use drugs to strengthen the walls of blood vessels and partially relieve inflammation, or use anti-inflammatory suppositories, limit physical activity. Many men do not want to do this, and in such cases, surgery makes sense.

Recovery after surgery

It is believed that three months after surgery, you can already watch, observe and do a control study of the spermogram again. But discomfort, pain, and pulling can be felt for up to six months. Some stretch it out for up to a year, because there is also phantom pain when the patient listens to his feelings. Of course, everyone heals differently. Since surgical treatment is associated with ligation of these very veins, subsequent collaterals are expected, because there are not only renal veins, but also veins to the adjacent testicle, veins to the iliac vessels, a large network of subcutaneous veins of the testicle, where blood can pass. The formation of these collaterals, which take all this blood, is exactly what takes time after the operation.

Risk of relapse

A person should still be monitored by a urologist, because there is always a possibility of relapse. And when a patient comes to the doctor, the doctor is probably obliged to say that surgical treatment is not a guarantee that the disease will not recur. Because of this, many conflicts arise when the doctor promises that everything will be fine after treatment, and the patient comes with a relapse. In the case of varicocele, the likelihood of relapse is high. Therefore, I think the most correct thing is not to deceive the patient and promise mountains of gold, you must always be honest with yourself and with him.

If you can do something, do it, and if there is a possibility of unsuccessful development, then it is better to tell the patient about it so that he is warned.

During the recovery period, you need to approach your health doubly carefully. Regarding sexual life, it is not advisable to have sex in the first month after surgery, usually men have no time for it at this time. Physical activity, of course, should be reduced and increased very slowly. Recovery after surgery is an extremely important period, a man should be careful even in small things, and sex and active physical exercise can harm a weakened body.

Effect on future offspring

Depending on when the man was operated on, the patient's ability to have children is assessed. If varicocele was detected at an early stage, the operation was successful, recovery was without complications, then the probability of conceiving a healthy child is high. If the point of no return has been passed, the testicle has decreased, and the spermatogenic layer has suffered, then even if we remove the cause of the changes, this will not give any result. The spermatogenic layer, unfortunately, is not restored.

The functionality of the cells should be enhanced, and we count on this when we perform operations. But we must understand that you can't jump above your head. There is no longer a harmful effect on those cells that remain, and they begin to work better, that is, they work for themselves and for those "neighbors" who are now gone. And although there are improvements, they do not occur many times over, a cell cannot work at once, say, for ten cells at a time.