Varicoceles are a relatively common condition (affecting approximately 10 percent of men) that tend to occur in young men, usually during the second or third decade of life. Sometimes these varicoceles cause no symptoms and are harmless, but sometimes a varicocele can cause pain, atrophy (shrinkage), or fertility problems.
Normally blood flows to the testicles through an artery and flows out via a network of tiny veins that drain into a larger vein that travels up through the abdomen. Varicoceles occur when there is a reverse of blood flow. This stretches and enlarges the tiny veins around the testicle to cause a varicocele, a tangled network of blood vessels also known as varicose veins.
One of the signs of a varicocele is an aching pain when the individual has been standing or sitting for an extended time and pressure builds up in the affected veins. Usually (but not always) painful varicoceles are prominent in size. Atrophy, or shrinking, of the testicles is another sign of varicoceles. The condition is often diagnosed in adolescent boys during a sports physical exam. When the affected testicle is smaller than the other, repair of the varicocele is often recommended. The repaired testicle will return to normal size in many cases.
There is an association between varicoceles and infertility or sub-fertility, but it is difficult to be certain if a varicocele is the cause of fertility problems in any one case. Other signs of varicoceles can be a decreased sperm count, decreased motility, or movement of sperm, and an increase in the number of deformed sperm. It is not known for certain how varicoceles contribute to these problems, but a common theory is that the condition raises the temperature of the testicles and affects sperm production.
Typical varicocele symptoms are mild and many do not require treatment. Treatment may be necessary if the varicocele is causing discomfort or any of the other problems listed above.
The diagnosis of Pelvic Congestion Syndrome is best confirmed using pelvic venography performed in the hospital. A pelvic ultrasound or other imaging study is performed prior to the venogram to rule out any anatomical abnormalities. A venogram is performed on an outpatient basis, and takes about two and a half hours from the time the procedure is started to the time you will leave the hospital. The procedure consists of inserting a thin plastic, flexible catheter about the size of a strand of spaghetti into the jugular vein in the neck. Dye is then injected into the veins of the pelvis and x-rays are taken. With the injection of dye, the interventionalist can visualize the abnormal reflux in pelvic varicosities. PCS is treated by placing tiny coils into the faulty veins to seal them off and relieve the aching pressure. The catheter is then removed and a small dressing is applied. After treatment, patients can often return to normal activity immediately.
Embolization is much less invasive than surgery. It also offers a proven, safe and minimally invasive treatment option to the traditional surgery such as hysterectomy. Although pelvic venogram is a viable treatment, other options do exist for treatment of pelvic congestion syndrome. Birth control pills or hormones may be used to stop menstrual cycles which may be beneficial in decreasing symptoms. Analgesics may be used to decrease pain. Surgical treatment is also available which includes a hysterectomy and tying off or removing the varicose veins.
Pelvic venogram offers a less expensive and less invasive effective treatment for pelvic congestion syndrome when compared to surgical treatment. Approximately 75 percent of women experience an improvement in their symptoms after the procedure. Although women’s symptoms usually improve, additional treatments may be necessary because veins in the groin or legs are still dilated and bulging.
If you are interested in this treatment or have questions, please call 801.379.6700 or send us a message.