Why Should You Get Treated for Varicocele?

In this article, I will convey important information to those diagnosed with varicocele disease who are undecided about evaluating treatment options. Before moving on to the answer to the question "What happens if varicocele is not treated?", I would like to make a brief reminder about varicocele symptoms.

Symptoms of Varicocele

We cannot generalize that every man with varicocele disease will show varicocele symptoms. In some patients, varicocele may not cause distinct complaints, but in some patients, the symptoms it causes can be severe enough to lower the quality of life. We can list the most common varicocele symptoms as follows:

• Sharp pain in the scrotum (the sac containing the testes)

• Shrinkage (testicular atrophy) or enlargement (swelling) of one or both testes

• Lump/Mass formation in the scrotum or testes

• Decrease in testosterone (male hormone) levels

• Decrease in sperm quality

The complaints experienced by the person can change the varicocele treatment approach. If the person has varicocele but does not plan to have children, does not suffer from pain caused by varicocele, and there is no obvious decrease in testosterone levels, the treatment option can be shelved. However, if the pain has reached unbearable dimensions, the testosterone level has dropped, the person wants to have children, and varicocele is shown as the cause of male infertility, treatment should be considered a necessity rather than a preference.

What Happens If Varicocele Is Not Treated?

If you do not undergo varicocele treatment, shrinkage occurs in your testis or testes where varicocele formation is observed. Although the exact cause of this condition, called testicular atrophy, is not fully known, it is known that it damages the ability of the testes to produce quality sperm.

Veins carry blood to the heart for oxygenation, but for their tasks to be fully performed, the veins must defy gravity. Veins escape the effect of gravity thanks to valves acting as gates. When vessel walls push blood up, the valves open, and when muscles relax, the valves close to prevent the backward flow of blood.

Over time, the opening and closing mechanism of the valves inside the veins can be damaged due to different reasons. Especially in advancing ages, with the loss of elasticity of the vessel walls and the dilation of the vessels, the valves begin not to close fully. This is exactly what is encountered in varicocele disease; structural changes occurring in the veins cause more blood than normal to accumulate in the testes (pooling). The blood accumulating in the testes raises the scrotal temperature, and the venous reflux flow formed in the testes leads to harmful agents reaching the testes; consequently, sperm quality decreases.

Male infertility is one of the natural consequences of untreated varicocele disease. When varicocele is not treated, the testes heat up more than normal, and the amount, quality, and motility of the produced sperm are affected by the heat increase.

The link between varicocele and low testosterone should also not be ignored. Clinical studies show that cells called "Leydig cells," which are responsible for testosterone production, deteriorate in varicocele patients. Improvement occurs in the functions of Leydig cells in men undergoing varicocele treatment, and if treated, the cells can fulfill their functions again.

Microsurgical Varicocele: The Gold Standard in Varicocele Treatment

Varicocele disease, which occurs as a result of the dilation of the veins around the testis and their failure to fulfill their functions, can be treated with microsurgical varicocelectomy surgery.

Microsurgical varicocele surgery ensures much more successful results compared to other types of varicocele surgeries. Being able to view the veins in detail under a microscope and ligating (tying off) the veins that are varicose or have the potential to become varicose ensures the protection of the testes from varicocele effects.

Thanks to the microsurgical varicocele operation, the patient can get rid of varicocele disease with a single surgery; when different techniques are applied (such as macroscopic surgery), the probability of varicocele recurrence is high.