How is varicocele treated?

Written by Chen Feng
Urology
Updated on September 13, 2024
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The treatment of varicocele depends on the severity of the condition. Clinically, some varicocele patients do not exhibit obvious symptoms, or show no symptoms at all and are only diagnosed during physical examinations. These patients can generally be treated conservatively by avoiding standing for long periods, avoiding prolonged walking, and by wearing tight underwear to alleviate symptoms of varicocele. However, some patients with varicocele do exhibit clear symptoms, including discomfort and pain in the scrotum on the affected side, especially after long periods of walking. These symptoms can become more severe and may also be accompanied by abnormalities in semen quality. These patients generally require surgical intervention, such as high ligation of the veins.

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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 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 Chen Feng
Urology
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What should be paid attention to after varicocele surgery?

The precautions to take after varicocelectomy surgery are as follows: 1. After the surgery, it is important to keep the surgical incision clean and dry to reduce the chances of infection. 2. In the postoperative diet, eat lightly, consuming more fresh vegetables and fruits, and moderately include protein-rich foods such as lean meat, fish, eggs, and milk. Protein supplementation is beneficial for the healing of the surgical incision. 3. Rest is crucial after surgery. Generally, it is advised to rest in bed, avoid standing for long periods, and refrain from extensive walking. Extended standing may cause discomfort and swelling of the scrotum, so more bed rest is recommended.

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Written by Zhang Xue Min
Vascular Surgery
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What is the cause of pain in varicose veins?

Varicose veins can sometimes cause localized pain, and there are several reasons for this pain. One reason is the formation of blood clots in the varicose veins, which can cause very obvious pain. Additionally, the affected area feels harder, not soft. When we say soft, it's like the softness of one’s lips; if it feels like the tip of the nose or the forehead, then it's considered very hard. In such cases, it indicates that the vein is not empty but contains a solid blood clot, which can cause pain. Another situation is if there is poor venous return in the proximal segment, causing the veins to fill significantly in a short time. This can also pull on the nerves outside the vein wall, leading to a sensation of pain.

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Vascular Surgery
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Can people with varicose veins in the lower extremities drink alcohol?

The majority of patients with varicose veins in the lower limbs can drink alcohol in moderation, but should not drink excessively. However, there is one circumstance where it is advisable to check carefully before deciding whether to drink alcohol. This is the case if there are severe varicose veins in both lower limbs and even some clearly visible dilated veins on the abdomen. In such cases, it's recommended to check the liver first. This is because the veins from the lower limbs join to form a vein called the inferior vena cava, which passes through the liver to return to the heart. If there is a problem with the liver, it may compress the inferior vena cava, causing varicose veins on both sides. In this situation, drinking alcohol could further damage the liver, potentially worsening the varicose veins.