The testes sit in the scrotum, outside the body, because they need a temperature slightly lower than the rest of the body to produce sperm efficiently. A varicocele is a swelling of the veins around the testis caused by weak vein valves, so that blood pools in them. This raises the temperature of the testis and causes oxidative stress, which can reduce sperm count and motility, increase abnormal forms and DNA damage, and in some men contribute to infertility.
Varicoceles are common, are found in about 15% of men, and often cause no symptoms; many are discovered during a fertility check-up. Larger varicoceles can cause a dull ache or heaviness in the scrotum.
Diagnosis
The doctor examines the man while he is standing and feels the upper scrotum, where a varicocele feels like a “bag of worms”. Asking him to cough or strain (Valsalva manoeuvre) makes the veins swell further.
Scrotal ultrasound shows the dilated veins around the testis, and colour Doppler measures blood flow and shows backflow (reflux) in the veins when the man strains.
When is treatment recommended?
Current guidelines recommend repair for a varicocele that can be felt on examination in a man with abnormal semen parameters and a couple trying to conceive. Microsurgical varicocelectomy has the lowest recurrence and complication rates; embolization by a radiologist is an alternative. Varicoceles seen only on ultrasound (subclinical) do not need repair. Because a sperm cycle takes about three months, semen improvement is usually checked three to six months after treatment. If the woman is older or other factors are present, going directly to IVF/ICSI may be more appropriate.
International Guidelines
In line with global standards, Dr. Sabry follows the latest recommendations from the American Society for Reproductive Medicine (ASRM), European Society of Human Reproduction and Embryology (ESHRE), and Royal College of Obstetricians and Gynaecologists (RCOG). Thus, patients receive care that is safe, ethical, and evidence-based.
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Why Choose Dr. Ashraf Sabry?
Dr. Ashraf Sabry, consultant in obstetrics, gynecology, fertility, and aesthetic gynecology, is recognized among the best OBGYN and fertility specialists in Cairo. With over 20 years of experience, he combines science and compassion to provide world-class care. Book your appointment through the contact page, WhatsApp, or call +201022224442.