- May 31, 2020
- Posted by: Prof Dr Coşkun Şahin
- Category: Testicular Diseases
What is Varicocele?
It is a disease that the veins of the testicle expand, fold, and the dirty blood circulation that is normally towards the heart returns to the testicle.
Varicocele is the swelling and swelling of the balls veins of the testicle. Pain (shown in blue) can cause swelling and infertility.
In varicocele disease, intravenous valves are defective. Dirty blood returns to the testicle again, causing it to warm up and deteriorate.
Who can have a varicocele?
Varicocele is a disease of young men. It is seen at any age from the age of 14. It usually happens on the left. It can be on the right or bilaterally.
What Kind of Complaints Does Varicocele Cause?
In addition to pain, it can be a fearful dream of young men in terms of causing infertility. Its treatment is only surgery.
Every Varicocele Case Is Surgery – Should It Be Treated?
If he does not have pain, did not have a negative effect on sperm count and properties, the person does not want children or does not have to be operated if they have enough children. However, if there is a pronounced varicocele, that is, when viewed from the opposite side, the swollen veins are visible in the left bag, if the egg on that side is shrinking, if the sperm count is adversely affected, these cases must be operated. There is also the most abused group in which there are no clinically observable varicoceles. However, varicocele has been reported on doppler ultrasound. We are not in favor of having varicocele surgery for these patients with normal sperm count. If the sperm count is low, it is necessary to look for doppler ultrasound if there is back ﬂow. If available, surgery may be recommended. Otherwise, the chances of beneﬁting from the surgery are weak and should be reported to these patients.
What Should Be in a Normal Sperm Male?
The number of sperm in a normal man should be more than 20 million in 1 ml, at least 50-60% should be alive, at least 25% of live sperm should move forward, normal sperm rate should be between 4-14% according to Kruger criteria.
The structure of a normal sperm: It consists of the head body and tail. The head part fertilizes the egg, the body part contains the energy source in reaching the egg. The tail part provides forward movement.
Very few of the millions of sperm cells are normal. Above, only the ﬁrst cell is normal and the others are abnormal.
How Should The Operation Be In The Patient With Varicocele? What is Microsurgery Focusing on?
The shape of varicocele surgery has changed throughout history. Tissue of testicular vessels in the abdomen, high inguinal incision, laparoscopic procedures, radiologically giving intravenous occlusions. These are no longer applied.
Open classical surgery is performed today by every physician. In this surgery, the veins seen with the naked eye are tied, and smaller veins can be bypassed. This can cause the disease to recur.
In classical varicocele surgery, the surgical wound is 2-3 cm tall, right next to the root of the penis.
What is Microsurgery Varicocele Surgery?
In microsurgery, surgery is performed under the microscope with larger images. Even small veins can be connected with approximately 8-16 times magniﬁcation.
Shown in blue are veins, red artery, white sperm channel. In the microsurgical method, only blue balls and veins are connected. In the microsurgical method, only the veins are connected. The red vein and white blood vessels are never touched.
The operation is performed under a microscope and using microsurgical instruments. It is important that the physician has a microsurgery certiﬁcate.
Physicians dealing with microsurgery must have a microsurgery certiﬁcate.
Is there any other beneﬁt of microsurgery?
Yes there is. Thanks to the microsurgical method, the arteries feeding the testicle can be protected, thus preventing future testicular atrophy or shrinkage. In addition, lymphatic white blood vessels are seen and not connected. Otherwise, a complication called hydrocele where water accumulates around the testicle can be caused. This means another unnecessary surgery in the future.
Is Microsurgery Varicocele Surgery Performed By Everyone?
It is useful to have it made for physicians with a microsurgery certiﬁcate.
Is there a downside to microsurgery varicocele surgery?
There is no negativity for our patients in microsurgical varicocele surgery.
Does Recurrence (recurrent) Varicocele Develop After Microsurgical Varicocele Surgery?
It develops at a negligibly low rate. Because in this surgery, all the veins are connected under the microscope, the arteries and white blood vessels can be fully protected.
When Do I Start My Current Activities After Surgery?
You can go out on the street the next day and do your work. It is necessary to be careful not to lift weights for a week.
How are Surgery Fees Determined?
It depends on the surgeon, whether it is bilateral or unilateral, the hospital where the surgery is performed.
Is Varicocele Surgery Necessary?
Varicocele surgery is not always necessary. Unfortunately, varicocele is one of the most frequently abused diseases in urological practice. If the varicocele is mild, the patient has no pain, no child anxiety, and the testicle has not shrunk, surgery is not required. There are some patients that there is no varicocele in the examination. However, varicocele has been reported with doppler ultrasound. In these patients, more care must be taken when deciding on surgery.