Varicocele

Varicocele is a dilatation of the spermatic cord. Occurs during puberty and most sexual potency, i.e. in the period of the highest tides of blood to the genitals. Localized in 95% of cases the left, where the conditions for the blood outflow from the scrotum worse than the right. It is explained by the peculiarities of the internal seminal vein, which empties into the right into the inferior Vena cava at an acute angle, while the left renal vein at right angle. The emergence of varicocele promote long standing, long sexual stimulation, weight lifting, Cycling , etc. Diagnosis on examination, the patient standing. Scrotum on the affected side mouth; in the course of the cord felt twisted, enlarged, easily crushed relentlessly Vienna. With the patient lying outflow of blood is facilitated and varicocele disappears. Rarely varicocele is a symptom of retroperitoneal tumor, which compresses the veins. In this case, the patient lying varicocele does not disappear.
Patients experience pain in the scrotum or groin, especially in the evening.
Often with age, disease spontaneously compensated. In case of progression can occur atrophy of the testicles. Possible infertility.
Prevention and treatment: restrict physical activity, regulation of sexual life, cool wiping, swimming , etc. Constant wearing jockstrap not shown, as it increases the temperature of the scrotum is more than acceptable for normal function of the testes. Indications for surgery: pain, disease progression, infertility. Operation: creation of the so called internal jockstrap, when saggy testicles tighten up, but the seed cord with veins wrap cut off by egg shells (operation Parona) or spermatic cord (Makara). With the same purpose use alloplastic materials (polyester) seed cord conclude in the soft case, which allows to eliminate the stagnation of blood in the veins and to keep intact the body's own tissue. Cm. also Varicose veins.

Dilatation of the spermatic cord (varicocele)

Varicocele means not only the extension, but the extension and excessive tortuosity 4-5 venous trunks, forming plexus pampiniformis and included into the spermatic cord. After passing through the inguinal canal, Vienna merge into the trunk v. spermaticae internae.
Dilatation of the spermatic cord is peculiar mainly people aged 17-30 years and are often; so, among conscripts varicocele is observed in 1-2% of cases. After 40 years of varicocele is rare.
Frequent tidal blood to the genitals, in the period of the most intense sexual function play a certain role in the pathogenesis of varicocele. However, the main reason is the weakness vanocnich walls, low location of the scrotum, a narrow gap between the veins, the small number of venous valves.
In 90% of cases varicocele is found on the left. The reason are less favorable conditions for venous to the left than to the right: 1) the left seminal vein drains into the renal vein at right angle, and the right into the inferior Vena cava at an acute angle; 2) v left. spermatica takes place in a narrow gap between the aorta and a. mesenterica superior; 3) on the left on v. spermatica puts pressure sigmoid colon, especially for constipation.
For idiopathic forms of varicocele is that it occurs only when the upright position of the body, while long walk. Lying varicocele disappears or diminishes sharply. Varicocele, does not disappear when the horizontal position of the patient, suspicious regarding germination or compression renal vein malignant tumor that originates from the kidneys.
In idiopathic varicocele the corresponding half of the scrotum hang down, the skin is stretched, tabla. Palpation is determined tangle soft extended strongly tortuous veins along the spermatic cord.
Often varicocele is asymptomatic. Sometimes patients complain of dragging pain, burning in the testicle or along the spermatic cord while walking, standing and physical stresses.
Treatment for varicocele conservative symptomatic; we must proceed from the fact that the disease for 40 years for the most part passes, and surgical methods for the treatment cannot eliminate its causes. Well carries his jockstrap, cool down your scrotum, eliminating constipation relieve pain and heaviness in the scrotum. Patients are encouraged to avoid a long walk and stand.
Only in rare cases you can use one of the many operational benefits, proposed for the treatment of varicocele. The main objectives of these operations the following: 1) creation of more favourable conditions for venous blood outflow from a testicle by moving it upwards; 2) creation of around varicose veins supporting connective tissue or muscle case. Is used for these purposes resection of the lower part of the appropriate half of the scrotum, fixing testicle to pahovom ring or the pubic bone, excision varices, wrapping the spermatic cord flap from the shells of the eggs or the cremaster. These operations give a high percentage of relapse, cause complications such as thrombosis, pus, and sometimes testicular atrophy due to the damage of a. spermaticae internae or nerves of the testis.