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The mechanism of the disease are as follows: the blood moves from the egg from the bottom up to the heart through the veins of the scrotum.
In the normal state the reverse blood flow valve prevents the unit walls of the veins, in the event of illness, these valves do not work as a result of impaired blood flow slows down and blood flow to the testicle, its functions are inhibited, symptoms of the disease, infertility.
The disease is fairly common, the diagnosis of varicocele by ultrasound reveals it at 35% male reproductive age. Typically, 98% cases, it is one-sided.
One of the causes of varicocele is a congenital weakness of the vascular wall due to the genetic predisposition of the body. Almost always, it turns out that the relatives of the patient have any problems with blood vessels or connective tissue defects of the heart valves, Varicose veins of the legs . phimosis . flatfoot or any other symptoms.
The second common cause of varicocele - increase in blood pressure in the veins of the scrotum and pelvis. Testicular Vienna can sometimes bend or pinch the other vessels that leads to narrowing of the lumen of the vein and increase the pressure therein. Venous network around the testicle under pressure increasingly expanding, and pronounced cases, the egg is surrounded by a mesh of veins.
Disrupted thermo function scrotum, the temperature rises in the testis, resulting in suppression of spermatogenesis, and male infertility. Factors that can not be called the cause of the disease, but more conducive to the development of the disease are excessive voltage abdominal muscles, weight lifting, chronic constipation or diarrhea .
Factor infertility, which require surgical treatment of varicocele are: an increase in temperature in the testis to body temperature and the suppression of normal spermatogenesis hypoxia eggs, reverse throw into the testes of biologically active substances from the kidneys and adrenal glands, accumulation in the testis tissue of free radicals, which are strong cell poisons and damage cells.
Symptoms of varicocele
Intrigue of the disease varicocele is that up to a state of neglect, it does not cause any anxiety and only detected during medical examinations. Most often the disease occurs during puberty, in a short time reaches a certain extent, and then is no longer progressing.
The young man may notice some increase, ptosis of the left half of the scrotum, there are unpleasant sensations in the groin, which intensified during exercise or sexual arousal. In determining the degree of varicocele pendulous scrotum begins to interfere with walking. In the upright position increases the left half of the scrotum. In advanced cases, there is a constant pain, the scrotum is significantly increased, the left testicle is reduced, there is a contouring convoluted veins.
In a laboratory study semen found a significant reduction in sperm count and motility.
Varicocele, depending on how heavily dilated veins testis and spermatic cord, is divided into four degrees of development:
0 degree - Varicose veins egg is not detectable and is determined only by the instrumental method or Doppler ultrasound.
1 degree - Symptoms are as varicocele veins, which is felt in an upright standing position.
2 degree - Veins greatly extended and palpated in any position.
Grade 3 - Pathological changes in the veins of the spermatic cord and the testicle can be determined visually.
Going one step varicocele to another is very rare.
Diagnosis of varicocele
In the diagnosis of varicocele, beginning in the second degree, is often sufficient visual inspection or palpation. Palpation can be carried out by Valsalva method When the patient natuzhitsya offer to get a more objective picture of, and with a positive result, further investigation is required.
At first degree varicocele is necessary to carry out a special examination of the scrotum - Doppler ultrasound or necessarily in two positions - standing up and lying down. This is a mandatory survey should be carried out with pain in the testicles or suspected infertility.
Be sure to do spermogramma - At least 2-fold and at intervals of 4-12 weeks. Before you must spermogrammoj week abstinence .
Spermogram
Study semen under a microscope is the only assay that allows to assess the ability of man to conceive a child. Note, however, that no deviation from the norm of semen does not mean the complete impossibility of conception. Any deviation indicators can mean a reduction in the probability of conception, but not completely eliminate it.
In order to give maximum semen objective results, we need proper preparation.
1. Weekly abstinence.
2. The weekly refusal of alcohol, drugs, caffeine.
3. The same period of abstinence from all heat treatments: hot tubs and showers, saunas, baths, solarium.
Repeated survey to comply with the same conditions. Sperm analysis obtained by masturbation, the condom material should be shipped within 3 hours for analysis.
In a laboratory study semen - semen, distinguishes between several stages testicular dysfunction :
Stage 1 - Indicators of concentration and motility normal, sometimes marked decrease in the concentration of spermatozoa with normal morphology.
Stage 2 testicular dysfunction - the concentration of sperm in the normal range, but there is a decrease in their mobility. During re-examination of the ejaculate may be more than 1, 5-fold variation of the main indicators of concentration, motility, morphology, total sperm count rarely decreases below 10 million.
Stage 3 characterized by signs of testicular atrophy - Reduction of the volume and density of the testicles. Sperm concentration was reduced to 5 million. / Ml or below.
Very often, when the symptoms of the disease do not appear varicocele and a man might not know about his illness before any medical examination on another occasion.
Treatment of varicocele
Non-surgical treatment of varicocele at the moment is not applied in medicine. The operation is performed by the following methods: conventional open surgery, endoscopic surgery, surgery of the small access microsurgical revascularization of the testicle.
Selecting the method of operation is carried out on the basis of analyzes and manifestations of the disease.
Prevention of varicocele
Due to the fact that the varicocele develops due to genetic predisposition or anatomical features, we are not talking about prevention. It is reasonable to be examined by a urologist after the completion of puberty.
If you have symptoms of varicocele It is necessary to follow some rules: to avoid problems with a chair and physical stress, which can lead to high blood pressure in the pelvic area. In principle, these measures is the prevention of varicocele as such.
If you experience pain in the testicles, the state will help alleviate a cold compress in the scrotum and the use of vasopressors.
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