What are the differential diagnosis of testicular varicocele when men stand for a long time
Recently, a 20-year-old young man discussed in the outpatient clinic and said that his left testicle had a swelling feeling, which made him feel faint pain. After standing for a long time, his symptoms worsened. After contact diagnosis, the patient's left scrotal earthworm-like vein mass was found. Through ultrasonic examination, the final diagnosis was left varicocele.
Varicocele refers to the circuitous 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% 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. The symptoms of fatigue, long time walking, strenuous exercise and sexual life worsen, and can be relieved after lying down and resting. Generally speaking, varicocele is often found in physical examination. Some patients find painless earthworm-like mass in the scrotum and then receive treatment. A few people were found during infertility treatment.
Physical examination and Doppler ultrasound are the most common methods to diagnose varicocele. 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, which can be used to promote blood circulation and tonify the kidney and essence, and observe the treatment effect for 3-6 months. If the effect is not good, further surgery can be used.
Some studies have shown that standing for a long time can easily lead to poor blood return of testicular veins and affect the spermatic veins in the scrotum. Therefore, it is recommended that men who need to stand for a long time walk or sit down every hour to rest.