Varicocele

Varicocele is the condition of excessive dilation of the veins responsible for sending venous blood from the testis to the testicle and, accordingly, an accompanying reflux in the blood circulation. Varicocele is a disease with the potential to cause progressive testicular damage.

While methods such as physical examination, scrotal doppler ultrasonography, venography, thermography, scintigraphy and magnetic resonance can be used in the diagnosis of varicocele, the diagnosis is usually made by physical examination and normally no additional imaging method is required. However, due to institutional (SGK, private insurance and other institutions) rules, the presence of varicocele must be diagnosed radiologically. Therefore, the most commonly used method is scrotal Doppler Ultrasonography.

 

In which cases are additional imaging methods used to diagnose varicocele?

1- In cases where a physical examination is difficult and problematic (patients with testicles located in the upper part of the scrotal sac, patients with small scrotal sac, patients with testicular sensitivity that prevents examination).

2. Anatomical features (obesity, accompanying hydrocele) that cause difficulties in physical examination necessitate the use of additional imaging methods.

 

THE INCIDENCE OF VARICOCELE DIFFERS BETWEEN PATIENT GROUPS

Varicocele has a low incidence in children under 10 years of age (about 1%),

While the incidence rate among all men is 15-20%,

It is encountered in 21-41% of men who apply for infertility and will have a child for the first time,

The incidence of varicocele in men who have had children before and who apply for infertility

is 75-81%.

 

WHAT IS A SUBCLINIC VARICOCELE?

Varicocele that cannot be detected during a physical examination but is diagnosed as a result of using radiological imaging methods is called a “subclinical varicocele”. The incidence of subclinical varicocele among all men is 35-62%. The effect of treating subclinical varicocele on sperm values and pregnancy rates has not been clearly demonstrated. Therefore, it is stated that subclinical varicocele should not be treated.