Does varicocele hurt?

Varicocele is different from varicose veins. Varicocele is mainly a common disease among men, and it will also have a certain impact on male fertility. A small number of patients may also experience swelling of the scrotum. Patients with varicocele will feel swelling and pain, so they must pay attention to treatment.

Typical symptoms

Patients often fail to receive timely diagnosis and treatment due to the lack of conscious symptoms, which ultimately leads to impaired spermatogenesis in some patients. A small number of patients may experience scrotal swelling when standing, and a localized persistent or intermittent feeling of heaviness, pain, and dull pain in the scrotum, which may radiate to the lower abdomen, groin area, or lower back. Symptoms worsen after fatigue, standing for a long time or walking, and are alleviated or disappear after lying down and resting.

Other symptoms

Accompanied by symptoms of neurasthenia such as insomnia, loss of appetite, dizziness, etc.

Diagnosis

1. Color Doppler flow imaging (CDFI) examination can intuitively and accurately observe the degree of expansion and blood flow status of varicocele, and is currently a non-invasive and accurate diagnostic method. 2. Subclinical VC: The diameter of the spermatic vein is ≥1.8mm, there is no blood reflux during quiet breathing, but reflux occurs in the Valsalva test, and the reflux phase is ≥800ms.

Causes

According to the cause, VC can be divided into primary and secondary VC.

1. Primary VC

Left-side varicocele is more common than right-side varicocele. The possible reasons are: ① Increased intravenous pressure because the left spermatic vein is long and merges into the left renal vein at a right angle; ② "Nutcracker" phenomenon (NCS), the superior mesenteric artery and aorta compress the left renal vein, affecting the return of the left internal spermatic vein and even causing reflux, which is the "Nutcracker" phenomenon (NCS); ③ Weak connective tissue around the internal spermatic vein and absent venous valves are common on the left side.

Relevant factors for the occurrence of primary varicocele: ① Absence or poor function of the varicocele valve leading to blood reflux; weakness of the varicocele wall and surrounding connective tissue, or incomplete development of the levator testis muscle and other anatomical factors. ③Upright posture affects spermatic vein return.