What should I do about varicocele?

Written by Chen Feng
Urology
Updated on September 12, 2024
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The treatment methods for varicocele vary based on the severity of the condition. Clinically, some patients with varicocele show no obvious symptoms and it is only discovered during a physical examination. These patients can generally be observed temporarily, and can also wear tight underwear or use a scrotal support to alleviate the condition. However, some patients do exhibit clear symptoms, such as a significant sensation of heaviness in the scrotum, especially after standing or walking for long periods, where the pain becomes more pronounced. These patients generally need to consider surgical treatment, where the main procedure involves high ligation of the spermatic vein. This can help alleviate symptoms and also improve the quality of semen.

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Written by Wang Shuai
Urology
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Can bilateral varicocele be cured?

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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Will varicose veins recur and have sequelae after surgery?

After varicose vein surgery, there may be a recurrence, and there may also be sequelae. The main reason for recurrence is that we only close off the varicose veins, but the causes that lead to varicose veins are not removed, such as some people having a family history, some being involved in long-term physical labor, and some being excessively obese. If these factors are not eliminated, the patient is very likely to relapse. The recurring veins may be some other nearby superficial veins that some surgical methods did not remove but merely closed locally. These veins might also reopen, and sequelae are possible. The most common sequelae include nerve damage, such as saphenous nerve damage, which is quite common with an incidence rate of about 14%. The main symptom is numbness near the inner ankle, which might improve over time. Some people feel discomfort at the surgical site on rainy or cloudy days shortly after surgery, and if the deep veins are damaged during surgery, more severe consequences may occur, including poor reflux in the deep veins and deep vein thrombosis, etc.

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Written by Zhang Xue Min
Vascular Surgery
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What are the effects of secondary surgery for varicose veins?

If varicose veins recur, we need to carefully investigate the cause of the recurrence and rule out problems in the deep venous system. If there is an obstruction in the deep veins, recurrence can occur quickly even after secondary surgery on the superficial veins. If the deep veins are only involved in venous reflux, surgery can still be performed, but it is hoped that medical compression stockings will be worn for a period of time after surgery. Otherwise, there is still a possibility of recurrence after the secondary surgery.

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Written by Zhang Xue Min
Vascular Surgery
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Late-stage complications of lower extremity varicose veins

In the advanced stages of lower extremity varicose veins, fixed ulcers can appear above the ankle in certain specific areas. These ulcers may improve or worsen intermittently and are long-lasting. The ulcers might gradually enlarge, and pigmentation can occur around them, with the skin gradually darkening, and even turning black. If these ulcers continue to remain unhealed for an extended period, there is a possibility of cancerous changes in some individuals. Therefore, it is essential to treat lower extremity varicose veins that have progressed to ulcers, with the primary treatments being compression therapy and medication, which can also be combined with surgical treatment.

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Written by Chen Feng
Urology
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Can varicocele heal itself?

Varicocele generally cannot be cured, and most patients with varicocele do not have any symptoms and only discover their condition during physical examinations. Such patients can temporarily be under observation, but they should regularly have their varicocele rechecked and also have their semen quality tested. If there are abnormalities in semen quality, timely surgical treatment is necessary. Clinically, a small number of varicocele patients exhibit significant symptoms, typically presenting as discomfort and pain on the affected side of the scrotum, especially after long periods of walking or standing, with pain becoming more pronounced. In such cases, prompt surgical intervention is generally necessary, and surgery can also improve the quality of the patient's semen.