Varicocele is one of the most common and surgically correctable causes of male infertility. Varicocele is the abnormal enlargement and varicosity of the veins (pampiniform plexus) within the scrotum, the sac that protects the testicles. It is generally observed in the left testicle due to anatomical reasons. To protect male reproductive health, the diagnosis and follow-up of varicocele must be carried out meticulously by specialist physicians.
What Are the Symptoms of Varicocele?
Many patients with varicocele do not experience any symptoms initially. However, as the condition progresses, the following complaints may arise:
- Testicular Pain: A dull ache that increases especially during prolonged standing, heavy sports, or hot weather, and decreases with rest.
- Irregularity in the Scrotum (Worm-like Appearance): Worm-like, curved vascular structures in the scrotum that can be felt by hand or seen from the outside as the veins become prominent.
- Testicular Shrinkage (Atrophy): Shrinkage in the size of the affected testicle due to impaired blood flow and accumulation of toxic substances.
Stages (Grades) of Varicocele
Varicocele is divided into 3 clinical stages (grades) based on physical examination findings:
- Grade I (Stage 1): The mildest stage. The veins are not visible from the outside and cannot be felt by hand. They are only felt during examination when the patient coughs or strains (Valsalva maneuver).
- Grade II (Stage 2): The moderate stage. The veins can be felt during physical examination while the patient is standing, even without straining, but they are not visible from the outside.
- Grade III (Stage 3): The most advanced stage. The veins are easily noticeable from the outside while standing, and a distinct varicose appearance is present in the scrotum.
The stage of varicocele is not always directly proportional to testicular damage. Therefore, even in a Grade I patient, sperm parameters may be significantly impaired.