Women Asked, I Answered: Frequently Asked Questions About Varicocele

The expectation of having a child and the familial problems it can lead to may damage the emotional bond between couples. Moreover, the thought that infertility stems solely from women, instead of evaluating treatment options, can carry the process of having a child to a point where it is difficult to reverse.

Thanks to increasing awareness that infertility, which is traditionally and socially associated with women, can arise from male factors, men are also turning to infertility treatments. Varicocele disease, which is among the detectable and treatable causes of male infertility, affects approximately 40% of infertile men.

So, "what is varicocele?". The answer to this question is wondered about quite a lot.

What is Varicocele?

To the question "What is varicocele?", I can briefly give the answer: "Varicocele is a condition characterized by the dilation (enlargement) of the veins surrounding the testis, the increase in the temperature of the testis or testes exposed to deoxygenated blood flow due to this, and the damage to testicular functions along with the increasing heat."

Varicocele disease can prevent having children naturally by lowering sperm quality over time as the testes are constantly exposed to high heat (hyperthermia). Varicocele usually affects the testis located on the left side due to the angle at which blood vessels in the body connect to each other.

Does Varicocele Go Away on Its Own?

During microsurgical varicocele surgery performed on patients diagnosed with varicocele as a result of physical examination and Color Doppler Ultrasonography, both the veins that have become varicose and the veins that have the potential to become varicose are closed (ligated). Thus, the recurrence of the disease is prevented.

A significant increase in sperm quality is experienced as a result of using vitamin-mineral supplements recommended after surgery, quitting smoking, and adopting healthy lifestyle habits. However, this disease does not go away on its own without any treatment.

Does Varicocele Affect Sexual Life?

As varicocele progresses, testosterone (male hormone) production may decrease as a result of damage to testicular functions. In this direction, sexual dysfunctions such as erectile dysfunction can be encountered in men. Therefore, varicocele can become a disease that affects sexual life.

Can One Have Children Naturally If Varicocele Is Not Treated?

The answer to this question may vary in line with the degree of progression of the patient's varicocele disorder. In the early period, varicocele may not cause any complaints or a decrease in sperm parameters to the extent that it prevents having children. Over time, the situation changes; as the testes are exposed to heat for a longer period, sperm quality gradually decreases, and this situation may create an obstacle to having children naturally.

Can Infertility Occur Later in Men Who Have Had Children Before?

One of the most curious issues is whether men who have had children in previous years will become infertile in later years (Secondary Infertility). First of all, I would like to say that I encounter such complaints very frequently. It is not always easy for couples who want to become parents again, even though they have children, to achieve their desires. In such a case, both women and men should be examined separately.

If I need to give information specifically on male-factor infertility, I can clearly state that varicocele disease can develop later and cause infertility problems in men later on. Fortunately, with advanced surgical techniques, it is possible to treat varicocele in selected patients and increase the probability of having children naturally by raising sperm quality.

Can a Man Who Has Had Varicocele Surgery Have Children?

I can say that the vitamin supplements given after varicocele surgery and the adoption of healthy lifestyle habits by men create an effect on sperm values that cannot be underestimated. Based on the fact that many of my patients on whom I performed microsurgical varicocele surgery have had children, I believe that couples who cannot have children due to varicocele should not fall into despair. The probability of having children both naturally and with Assisted Reproductive Technologies (ART) after varicocele surgery is quite high.

How is Varicocele Diagnosed?

Definite results can be obtained with Scrotal Color Doppler Ultrasonography during varicocele diagnosis. The treatment of this disease, which can be diagnosed even with the naked eye, that is, only with physical examination as a result of the veins becoming prominent in advanced cases, must be planned by evaluating varicocele symptoms and the health status of the couples. Varicocele treatment is planned in line with Color Doppler Ultrasound results in men who experience pain in the testis and groin region, are diagnosed with infertility, and whose quality of sexual life decreases due to low testosterone.

Why is Varicocele Surgery Performed with Microsurgery?

Microsurgical Varicocelectomy is accepted as the gold standard in the treatment of varicocele disease. Since all veins that are varicose and show signs of becoming varicose are closed under a microscope, the technique has a natural superiority.

Recurrence problems can be seen after open varicocele surgery, but the probability of the disease recurring after varicocele surgery with microsurgery is almost non-existent. The operation is completed in approximately 45 minutes under spinal anesthesia, and if patients are operated on in the morning, they can be discharged in the evening.

Spousal Support is Needed in the Post-Surgery Process Every man needs the support of his spouse in the pre- and post-operative process. The operation part of the process should be thought of as a declaration of intent, and couples should cling to each other in this process. While it is more difficult for men to adopt healthy lifestyle habits alone in the post-operative period, all changes gain meaning with the support of their spouses. Therefore, it is not correct to reduce infertility only to the woman or the man; spouses must give full support to each other for the success of the treatment process.

What Happens If Varicocele Is Not Treated?

Performing varicocele treatment cannot be described as an obligation. The treatment decision is made according to the simultaneous evaluation of couples and the nature of the complaints experienced by the patients. If symptoms such as infertility, pain, or a decrease in testosterone levels are in question, treating varicocele is recommended. If varicocele is not treated, both sperm quality and testosterone production decrease gradually. Therefore, varicocele surgery is also recommended to those who do not want to have a baby but want to keep their sexual life quality high or get rid of the pain problem.