And whether you know...
July 5, 2011
The illness mechanism in the following: blood moves from a small egg from below up, to heart on scrotum veins.
In a normality the retrograde blood flow is interfered by the valve device of a wall of veins, when developing an illness these valves do not work, as a result the blood stream is slowed down and blood supply of a small egg is broken, its functions are oppressed, disease symptoms, infertility appear.
The illness is rather frequent, diagnosis to a varikotsela by means of ultrasound reveals it at 35% of men of reproductive age. As a rule, in 98% of cases, it happens unilateral.
One of origins to a varikotsela is inborn weakness of a vascular wall owing to genetic predispositions of an organism. Almost always it becomes clear that relatives of the patient have any problems with vessels or connecting fabric: defects of valves of heart, varicosity of legs, phymosis, flat-footedness or some other manifestations.
The second frequent reason of emergence for a varikotsela – increase of pressure of blood in veins of a scrotum or a small pelvis. The Yaichkovy vein can sometimes be bent or pressed by other vessels that leads to narrowing of a gleam of a vein and increase of pressure in it. The venous network around a small egg under the influence of pressure more and more extends, and in pronounced cases, the small egg appears in a grid environment from venous vessels.
Temperature-controlled function of a scrotum is broken, temperature in a small egg increases that leads to suppression of a spermatogenesis and man's infertility. Factors which it is impossible to call a cause of illness, but, the excessive muscle tension of a prelum abdominale, a raising of weights, chronic locks or diarrhea are to a large extent promoting a course of a disease.
Infertility factors at which the varikotsela needs surgical treatment are: temperature increase in a small egg to body temperature and suppression of a normal spermatogenesis, a small egg hypoxia, the return throwing in testicles of biologically active agents from kidneys and adrenal glands, accumulation in fabric of a small egg of free radicals which are strong cellular poisons and damage cells.
Symptoms to a varikotsela
Insidiousness of an illness to a varikotsela is that up to the started states, it does not cause any concern and it is found only during medical examinations. Most often the illness arises during puberty, for short term reaches some degree and then does not progress any more.
The young man can notice some increase, omission of the left half of a scrotum, there are unpleasant feelings in a groin which amplify at an exercise stress or sexual excitement. At certain degrees the varikotsel the loose-hanging scrotum begins to prevent walking. In vertical position the left half of a scrotum increases. In the started cases there are constant pains, the scrotum considerably increases, the left small egg decreases, the konturirovaniye of gyrose veins is observed.
At laboratory research of sperm considerable decrease in quantity of spermatozoa and their mobility is found.
Varikotsele, depending on that, veins of a small egg and a seed cord are how strongly expanded, is divided into 4 extents of development:
0 degree — a varicosity of a small egg is not probed and defined only instrumentalno by the ultrasonography methods or doppler sonography.
1 degree – symptoms to a varikotsela consist in a phlebectasia which is probed only in vertical position standing.
2 degree – veins are strongly expanded and are probed in any situation.
3 degree – pathological change of veins of a small egg and seed cord can be defined visually.
Transition of one stage to a varikotsela in another happens very seldom.
Diagnosis to a varikotsela
At diagnosis to a varikotsela, since the second degree, often there is sufficient a visual survey or a palpation. The palpation can be carried out by Valsalva's method when to the patient suggest to natuzhitsya to receive more objective picture and at a positive take of additional inspection it is not required.
At the first degree the varikotsela needs to conduct special examination of a scrotum — ultrasonography or doppler sonography, it is obligatory in two provisions – standing and lying. The same examination without fail needs to be conducted at pains in testicles or suspicion on infertility.
Surely the spermogram – not less than 2-fold and bucketed in 4-12 weeks becomes. Before a spermogram week sexual abstinence is necessary.
Carrying out research of an ejaculate under a microscope, is the only analysis allowing to give an assessment to ability of the man to conception of the child. However it is necessary to consider that no aberration of indicators of a spermogram, means an utter impossibility of conception. All deviations of indicators can mean only decrease in probability of conception, but not completely exclude it.
In order that the spermogram yielded the most objective results, the correct preparation is necessary.
1. Week sexual abstinence.
2. Week refusal of alcohol intake, medicines, caffeine.
3. Same abstention term from all thermal procedures: hot bathtubs and shower, sauna, bath, sunbed.
At repeated inspection to meet the same conditions. Sperm on the analysis turns out by masturbation, the condom with material has to be sent within 3 hours to the analysis.
At laboratory research of sperm – the spermogram, distinguishes several stages of testicular dysfunction:
1 stage — indicators of concentration and mobility of spermatozoa normal, is sometimes noted falling of concentration of spermatozoa with normal morphology.
2 stage of testicular dysfunction — concentration of spermatozoa within norm, but are noted decrease in their mobility. At repeated research of an ejaculate perhaps, more, than 1,5-fold change of the main indicators of concentration, mobility, morphology, total quantity of spermatozoa is seldom reduced lower than 10 million.
3 stage are characterized by signs of an atrophy of testicles — decrease in their volume and density of testicles. Concentration of spermatozoa is reduced to 5 million/ml or below.
Cases when at a disease symptoms to a varikotsela are not shown are very frequent and the man can not know about the illness before any medical examination in other case.
Treatment to a varikotsela
Varikotsele is not a dangerous disease, life-threatening and the indication to an operative measure only infertility of the patient, resistant pain in the field of testicles, esthetic defects of a scrotum and the termination of growth owing to a small egg illness during puberty is.
Not operational treatment to a varikotsela in medicine is not applied at the moment. Operation is performed by the following methods: usual open operation, endoscopic operation, an operative measure from pass access, microsurgical revascularization of a small egg.
The choice of a method of operation is carried out on the basis of analyses and displays of a disease.
Prevention to a varikotsela
Because to a varikotsela develops because of genetic predisposition or anatomic features, the speech about prevention does not go. It is reasonable to pass inspection at the urologist after end of the period of puberty.
If there were symptoms to a varikotsela, then it is necessary to follow some rules: to avoid problems with a chair and a physical overstrain which can lead to increase of a blood pressure in a small pelvis. In principle, these measures are also prevention to a varikotsela per se.
When developing pains in testicles, the cold compress in the field of a scrotum and use of vasoconstrictive drugs will help to facilitate a state.