Can bilateral varicocele be cured?

Written by Wang Shuai
Urology
Updated on August 31, 2024
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After the occurrence of varicocele, some patients may experience a feeling of heaviness and pain in the scrotum, which is often more apparent after prolonged standing, sitting, or intense exercise, and gradually alleviates after lying down and resting. During physical examination, tortuous veins similar to earthworms can be felt inside the scrotum. A color Doppler ultrasound examination is needed for further clarification. For bilateral varicoceles, it is currently curable. The main treatment method is surgical intervention, such as laparoscopic high ligation of the spermatic veins on both sides. This surgical approach is a minimally invasive procedure and the surgical outcomes are quite definite. Generally, a recovery period of 3-6 months after surgery is expected before complete recovery.

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Written by Zhang Xue Min
Vascular Surgery
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The difference between thromboangiitis obliterans and varicose veins

Firstly, these are two completely different diseases. Thromboangiitis obliterans is an inflammatory vascular disease involving the medium and small veins and arteries, causing migratory superficial phlebitis and leading to the obstruction of the veins, as well as some obstructions in the lower limb arteries. Thus, thromboangiitis obliterans includes some obliterative diseases of both arteries and veins, the cause of which is an autoimmune inflammation. Varicose veins are one of the most common vascular surgical diseases. They primarily manifest as tortuous, clustered, and dilated superficial veins of the lower limbs. This condition does not involve arterial changes, but varicose veins can progressively worsen and may lead to pigmentation and ulceration, which at that time necessitates differentiation from arterial ulcers. Generally, the ulceration in varicose veins is located in the "gaiter area," which is the area covered by a boot when wearing one, including the lower one-half to one-third of the lower leg. Most of the ulcers from varicose veins primarily appear above the inner ankle. The ischemia caused by thromboangiitis obliterans leads to a dry-type ischemia, where the limbs can gradually become dry, shriveled, atrophied, and blackened, with ulcers typically beginning from the extremities.

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Written by Zhang Xue Min
Vascular Surgery
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Can varicose veins occasionally be invisible?

When varicose veins are mild in their early stages, if you wear compression stockings during winter, it's possible that the varicosities are not very noticeable occasionally when you take off the stockings. However, in more advanced stages, when there are clearly widespread and clustered varicose veins, they are difficult to conceal. However, if deep vein thrombosis occurs, causing tissue edema, the swollen surrounding tissues may obscure the varicose veins, making them less visible. Therefore, we need to judge based on the specific circumstances. Generally, just because varicose veins are occasionally not visible does not mean that the condition has healed.

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Written by Zhang Xue Min
Vascular Surgery
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Will wearing compression stockings every day help with Grade 2 varicose veins?

In the grading of varicose veins, Grade II signifies that there are obvious superficial vein tortuosity and dilation, and some may even clump together, but without edema and pigmentation. For patients with such newly developed varicose veins, persisting in wearing compression stockings can possibly lead to improvement. The main principle here is that in patients with newly developed Grade II varicose veins, the damage to the venous valves may not be severe, but rather due to venous pressure causing vein dilation, resulting in the valves not closing tightly. In such cases, if we apply external force to ensure the valves close tightly, preventing further vascular dilation and reducing the force of damage to the valves, then there is a possibility of recovery to a certain extent. If the condition has been present for a longer time, and this valvular dilation has already resulted in long-term effects, wearing compression stockings might only help in reducing the potential for further progression, but it is unlikely to improve existing varicose veins significantly.

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Written by Zhang Xue Min
Vascular Surgery
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How to treat varicose veins stage II?

If you're referring to the second stage of varicose veins, I'm not sure if you mean the clinical manifestation stage two, or if it's a recurrence after one surgery. Let's first talk about stage two varicose veins, which means there are visible and tortuous vein clumps. There are several main treatment methods for this condition: First, conservative treatment, which involves wearing medical compression stockings. If symptoms include soreness, heaviness, or cramping, some medications can be taken orally. Then, if there is a desire for surgical treatment, options like vein stripping, radiofrequency, or laser treatments are available. Some may involve sclerotherapy or another method called venous angle keratin treatment, specifically for stage two varicose veins. If it's a recurrence of varicose veins, we need to assess the specific situation. Some people might have had previous endovenous closure surgeries, and their veins are still present. In such cases, we can choose to redo the closure or opt for surgery to remove them. Another scenario is if the varicose veins have recurred after surgery. We need to investigate the cause. Some people might have iliac vein stenosis, and in such cases, treatment targeted at the iliac vein is necessary.

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Written by Wang Shuai
Urology
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What are the harms of varicose veins?

The harms of varicocele are mainly manifested in the following aspects. The first aspect is that varicocele causes a sensation of dragging pain in the testicles, affecting the patient's normal work and life. The second aspect is that due to the presence of varicocele, there is a decline in the quality of male semen, which affects male fertility. The third aspect is that if the varicocele is severe and persists for a long time, it may lead to testicular atrophy, resulting in a decrease in the level of testosterone secretion by the testicles, which reduces male sexual function. Therefore, patients with varicocele, especially those with decreased semen quality, should actively seek surgical treatment, which currently mainly involves high ligation of the spermatic vein.