Post Date December, 03 2023
Recently, a 20-year-old boy came to the clinic for consultation and said that he always felt the swelling of his left testicle, which made him feel faint pain. After standing for a long time, the symptoms worsened. After palpation, I found that there was an earthworm-like venous mass in the left scrotum of the patient. Through B-ultrasound examination, the final diagnosis was left varicocele.
Varicocele refers to the tortuous expansion of the racemose venous plexus in the spermatic cord due to the obstruction of reflux. The prevalence of varicocele in adult males is 10% - 15%, of which 25% will affect fertility. Most patients have no obvious symptoms, and some patients show swelling and dull pain at the scrotum and testis, and some patients are accompanied by scrotal dampness. Symptoms will worsen after tiredness, long time walking, strenuous exercise and sexual life, but can be relieved after lying down and resting. In general, varicocele is often found during physical examination, and some patients find painless earthworm-like mass in the scrotum and then go to see a doctor, while a few people find it when they go to see a doctor because of infertility.
In clinic, the most common method to diagnose varicocele is physical examination combined with Doppler ultrasound. For the treatment of varicocele, if there is no clinical discomfort or other symptoms, if there is no desire to have a baby recently, the treatment may not be given temporarily; But if there is local discomfort, it should be actively treated. There are two methods of treatment, medicine and surgery. Generally, the first step is to use drugs for conservative treatment, and observe the treatment effect for 3 to 6 months with traditional Chinese medicine of promoting blood circulation and tonifying kidney and essence. If the effect is not good, further surgery can be used.
Some studies have shown that standing for a long time is easy to cause poor blood return of testicular veins, and affect the spermatic veins in the scrotum. Therefore, it is suggested that men who need to stand for a long time should walk or sit down for a rest every hour.
(Intern editor: Chen Hao)
