Sexual Medicine, Fertility, Urology and Andrology in Seville

VARICOCELE

What is a Varicocele?

A varicocele is a varicose dilatation of the veins of the spermatic cord in the scrotum. It can be defined as the presence of varicose veins in the testicle and spermatic cord.

How common is this condition?

It occurs in approximately 11% of the general population, 25% of men with abnormal sperm analyses, between 35% and 40% of men with primary infertility (those who have not yet had any children) and between 70% and 80% of men with secondary infertility (those who have difficulty having children after having had a child previously).

Why does it happen? What causes it?

It is much more common on the left side (90%), due to the special anatomy of the gonadal veins on that side where, more specifically, compression at the mouth of the spermatic vein usually occurs, causing a progressive expansion in the cord and testis.

What impact can it have?

The varicocele is often accompanied by a decreased testicular size and consistency. It causes progressive damage  and results in progressive sterility. The incidence of discomfort and pain associated with testicular varicocele is between 2% and 10%.

What are the potential benefits of treatment?

Surgical repair of varicocele stops  deterioration of the function of the affected testicle and in over 70% of cases improves fertility, improves sperm parameters, reduces sperm DNA fragmentation and increases the percentage of pregnancies. Current evidence suggests that treatment of varicocele should be considered first in infertile couples with no other cause of infertility, due to its low risk and the good relation between cost and benefits.

How is varicocele surgery performed?

Varicocele can be treated in many ways: by interventional radiology, laparoscopic, or by conventional surgery using retroperitoneal, inguinal and subinguinal approaches. The best procedure is currently subinguinal microsurgery because this technique achieves the highest rates in healing, in seminogram and spontaneous pregnancy; it also has a lower percentage of complications (recurrence, persistence, hematoma, infection, hydrocele and testicular atrophy).

What is Varicocele microsurgery?

The intervention on Varicocele is performed using an operating microscope or optical magnification, allowing a better differentiation of the ions and preventing secondary damage during the surgery, which is more common in conventional methods (not micro-surgery).

Dr. Natalio CruzJefe del servicio de Andrología
El Dr. Cruz, con 25 años de experiencia médica, ha sido hasta 2016 Jefe de la Unidad de Andrología en el Servicio de Urología del Hospital Virgen del Rocío de Sevilla, Coordinador Nacional de Andrología de la Asociación Española de Urología (AEU) y Secretario General de la ESSM, cargos que ha delgado para centrarse de lleno en el ilusionante proyecto de ofrecer una consulta médica privada de alto nivel en Sevilla.

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