DIFFERENT MODALITIES OF MANAGEMENT OF VARICOCELE
Hussein Yahya Sayed;
Abstract
Varicocele is an abnormal dilation of the spermatic venous or pampiniform plexus of the testicle, it is usually asymptomatic, although it may cause pain or a heavy sensation in the scrotum, and it may contribute to infertility. Commonly found as an incidental finding as part of infertility investigations(Gulino et al., 2011).
Several theories have been proposed to explain its occurrence, including poorly functioning valves and increased resistance to blood flow where the varicocele veins drain, creating a “dam-like” effect and increasing venous pressure. It does not cause cancer and is not life threatening. (Rodriguez et al., 2009).
Pain from varecocele is generally mild to moderate, occurs with long periods of sitting, standing or activity and is relieved by lying down. Although it can be uncomfortable before bedtime (after a long day of activity), it generally does not occur upon awakening after a night’s rest. The pain is dull, congestive‚ “tooth ache” like and generally doesn’t refer elsewhere. It is not associated with urination issues or erectile dysfunction; however, it is associated with male infertility. Lastly, when large, a varicocele can cause a clumpy “bag of worms” (Fayez et al., 2010).
The “gold standard” way to diagnose varicoceles is by physical examination with a patient in a standing position, palpation of the scrotum by a well-trained physician can reveal a varicocele. Exercise and prolonged standing may also demonstrate a varicocele. Difficulties palpating avaricocelearisewhen the scrotal wall is thick or contracted. In addition, benign fat, termed lipoma of the cord, can feel like a variocele. Unlike a varicocele, however, a lipoma will not go away when the patient lies down.The diagnosis of varicocele can also be made with venography,ultrasound,thermography, scintigraphy and CAT scan or magnetic resonance imaging. Venography is considered to be the best diagnostic test, but it is invasive, involving catheterization of large leg veins to access this system(Gulino et al., 2011)
Several theories have been proposed to explain its occurrence, including poorly functioning valves and increased resistance to blood flow where the varicocele veins drain, creating a “dam-like” effect and increasing venous pressure. It does not cause cancer and is not life threatening. (Rodriguez et al., 2009).
Pain from varecocele is generally mild to moderate, occurs with long periods of sitting, standing or activity and is relieved by lying down. Although it can be uncomfortable before bedtime (after a long day of activity), it generally does not occur upon awakening after a night’s rest. The pain is dull, congestive‚ “tooth ache” like and generally doesn’t refer elsewhere. It is not associated with urination issues or erectile dysfunction; however, it is associated with male infertility. Lastly, when large, a varicocele can cause a clumpy “bag of worms” (Fayez et al., 2010).
The “gold standard” way to diagnose varicoceles is by physical examination with a patient in a standing position, palpation of the scrotum by a well-trained physician can reveal a varicocele. Exercise and prolonged standing may also demonstrate a varicocele. Difficulties palpating avaricocelearisewhen the scrotal wall is thick or contracted. In addition, benign fat, termed lipoma of the cord, can feel like a variocele. Unlike a varicocele, however, a lipoma will not go away when the patient lies down.The diagnosis of varicocele can also be made with venography,ultrasound,thermography, scintigraphy and CAT scan or magnetic resonance imaging. Venography is considered to be the best diagnostic test, but it is invasive, involving catheterization of large leg veins to access this system(Gulino et al., 2011)
Other data
| Title | DIFFERENT MODALITIES OF MANAGEMENT OF VARICOCELE | Other Titles | الطرق المختلفة لعلاج دوالي الخصيتين | Authors | Hussein Yahya Sayed | Issue Date | 2016 |
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