Testicular discomfort

When male friends feel testicular discomfort, it may be because the underwear they wear is too tight and squeezes the scrotum. At this time, we should adjust it. Inflammation such as orchitis can also cause testicular discomfort. We should learn to judge its cause. If the testicular discomfort affects the normal erection of the penis, it may be a male disease. If it does not affect the normal erection, it is generally caused by external factors.

Varicocele (VC) is a vascular disease, which refers to the abnormal dilation, elongation and tortuosity of the spermatic veins in the spermatic cord, which can cause pain and discomfort and progressive testicular dysfunction. It is one of the common causes of male infertility. It has attracted widespread attention due to its related scrotal pain and discomfort, infertility and testicular atrophy. It is a common male urogenital disease. It is more common in young men, with an incidence rate of 10% to 15% in the normal male population and 19% to 41% in male infertility. Varicocele is a vascular spermatogenesis disorder caused by the dilation of the spermatic veins and the vaginal veins surrounding the spermatic cord. It is usually seen on the left side, accounting for about 77% to 92%, and can also occur on both sides, accounting for about 7% to 22%. It is rare to occur on the right side, accounting for about 1%. Traditional surgery uses an inguinal incision, high ligation of the internal spermatic vein, and removal of part of the dilated vein in the scrotum.

The prevalence of varicocele in the general male population is 10% to 15%, 30% to 40% in primary male infertility, and 69% to 81% in secondary infertility. The probability of first-degree relatives of patients with varicocele is significantly increased: 21.1% of fathers and 36.2% of brothers may both have varicocele.

Varicose vein varicocele can be divided into adult type and adolescent type according to age. It can be divided into primary type and secondary type according to etiology.

Causes

According to the cause, VC can be divided into primary and secondary VC.

1. Primary VC

Varicose veins are more common on the left side than on the right side. The reasons may be:

① Increased intravenous pressure because the left spermatic vein is long and joins the left renal vein at a right angle;

② "Nutcracker" phenomenon (NCS), the superior mesenteric artery and aorta compress the left renal vein, affecting the reflux of the left internal spermatic vein and even causing reflux, which is the "Nutcracker" phenomenon (NCS);

③ Weak connective tissue around the internal spermatic vein and absence of venous valves are common on the left side.

Factors related to the occurrence of primary varicocele:

The absence or dysfunction of the spermatic vein valve leads to blood reflux; it is caused by anatomical factors such as weakness of the spermatic vein wall and surrounding connective tissue, or incomplete development of the levator testis muscle. The upright posture affects the spermatic vein reflux.

2. Secondary VC

Causes and diseases include: obstruction of the left renal vein or caval vein by tumor thrombus, renal tumor, intra-abdominal or retroperitoneal tumor, obstruction of the left renal vein or caval vein by tumor thrombus, renal tumor, pelvic tumor, huge hydronephrosis, ectopic blood vessels compressing the ascending spermatic vein, etc.

Clinical manifestations

Patients often do not receive timely diagnosis and treatment due to lack of conscious symptoms, which eventually leads to impaired spermatogenesis in some patients. A small number of patients may experience scrotal swelling when standing, localized persistent or intermittent swelling pain, dull pain and blunt pain in the scrotum, which may radiate to the lower abdomen, groin area or lower back. Symptoms worsen after fatigue, prolonged standing and walking, and are relieved or disappear after lying down and resting.