Varicocele (enlarged veins in the scrotum)Varicocele (scrotum ki rag-on ka soojna)

Varicocele kya hai

Khoon testicle se chhoti chhoti rag-on (veins) ke aik jaal ke zariye bahar nikalta hai jo scrotum ke andar upar ki taraf jati hain. Varicocele us waqt hota hai jab yeh veins soojh kar ainth jati hain, bilkul taangon ki varicose veins ki tarah. Yeh aam tor par baayen (left) taraf hota hai, aur kabhi kabhi dono taraf.

Varicocele aam tor par nuqsan deh nahi hota. Yeh cancer nahi hai, aur infection bhi nahi.

Meherbani karke sharmayen nahi. Varicocele urologist ke paas aane ki aik aam wajah hai, aur bohat se mard bina jaane is ke saath zindagi guzaar dete hain.

Yeh kitna aam hai

Varicocele aam hain, aur yeh sab se ziyada nau-jawan larkon aur jawan mardon mein milte hain. Bohat se mard ittefaq se jaan jate hain, masalan kisi check-up ke dauran ya jab fertility ki jaanch ho rahi ho.

Aam alamaat

Bohat se mardon mein koi alamat nahi hoti. Doosre yeh mehsoos karte hain:

• Scrotum mein halka dard ya bhaari pan, jo aksar der tak khade rehne ke baad ya din ke aakhir mein barh jata hai, aur let jane par behtar ho jata hai.
• Testicle ke upar naram, ubhra hua ehsaas, jaise chhoti chhoti doriyon ka uljha hua gucha.
• Scrotum mein nazar aane wali soojan, khaas tor par khade hone par.
• Aik testicle jo doosre se zara chhota ho.

Varicocele us waqt bhi pakra ja sakta hai jab miyan biwi ko bachche ke liye mushkil ho rahi ho.

Yeh kyun hota hai

In rag-on mein chhote chhote valves hote hain jo khoon ko upar ki taraf behte rehne mein madad dete hain. Jab yeh valves theek kaam nahi karte to khoon rag-on mein jama ho jata hai aur woh soojh jati hain. Aam tor par yeh sirf rag-on ki banawat ka masla hota hai.

Varicocele bhaari cheezein uthane, cycle chalane, garmi, warzish, ya maazi mein kiye gaye kisi kaam se nahi hota. Meherbani karke apne aap ko qasoorwar na thehrayen.

Aisa varicocele jo achanak nazar aaye, sirf daayen (right) taraf ho, ya let jane par chhota na ho, doctor ko zaroor dikhana chahiye, kyunke bohat kam sahi, koi aur masla is ke peeche ho sakta hai.

Yeh kyun ahem ho sakta hai

Varicocele wale bohat se mardon ko koi masla nahi hota, aur har kisi ko ilaaj ki zaroorat nahi hoti. Lekin kuch mardon mein varicocele:

• aisi takleef ya dard paida kar sakta hai jo rozmarra zindagi mein rukawat bane;
• sperm ki quality par asar daal sakta hai, jis se bachche ka baap banna mushkil ho sakta hai;
• khaas tor par nau-jawan larkon mein testicle ki barhat sust kar sakta hai.

Aap ka urologist aap ko faisla karne mein madad dega ke in mein se koi aap par lagu hota hai ya nahi.

Tashkhees kaise hoti hai

Aap ka urologist aam tor par:

• Sawalaat poochega: kya aap ko alamaat hain, aur kya aap aur aap ke saathi bachche ki koshish kar rahe hain.
• Khade hone ki halat mein muaina karega, aur kabhi kabhi aap ko halka sa khansne ya zor lagane ko kahega, kyunke is se rag-on ko mehsoos karna aasaan ho jata hai. Let kar bhi muaina ho sakta hai.
• Zaroorat ho to scrotum ka ultrasound likhega. Yeh dard ke baghair hota hai, aur rag-on aur testicles ka size dikhata hai.
• Semen test (semen analysis) likhega, agar fertility ki fikr ho. Aap aik sample dete hain, aur laboratory usay microscope ke neeche dekh kar sperm ki tadad, harkat aur shakal check karti hai. Sample dene ka sahi tareeqa laboratory aap ko batayegi.

Kabhi kabhi blood tests ka bhi mashwara diya jata hai. Aap ka urologist wajah samjhayega.

Nau-jawan larkay

Varicocele aksar balooghat (puberty) ke aas paas pehli baar nazar aata hai. Zyadatar larkon mein yeh koi masla nahi karta. Kyunke yeh kabhi kabhi testicle ki barhat par asar daal sakta hai, is liye jis larke ko varicocele ho usay doctor ko dikhana chahiye, jo waqt ke saath dono testicles ka size muaine se, aur kabhi kabhi ultrasound se, check kar sakta hai. Agar mutasira taraf ka testicle doosre jitna nahi barh raha, ya us mein dard ho, to ilaaj ka mashwara diya ja sakta hai.

Agar aap ke bete ko varicocele hai, to meherbani karke usay tasalli dein ke yeh aam hai aur us ne kuch ghalat nahi kiya.

Ilaaj ke tareeqay

Bohat se mardon ko kisi ilaaj ki zaroorat nahi hoti. Ilaaj aam tor par tab socha jata hai jab musalsal dard ho, jab miyan biwi ko bachche mein mushkil ho aur semen test ghair-mamooli ho (saathi ki jaanch ke baad bhi), ya jab kisi larke ka testicle theek se na barh raha ho. Mukhya tareeqay yeh hain:

Ilaaj kuch mardon mein sperm ki quality behtar kar sakta hai, lekin yeh hamal (pregnancy) ki zamanat nahi de sakta, aur har kisi ko faida nahi deta. Fertility par bohat si cheezein asar daalti hain, is liye dono saathiyon ki jaanch honi chahiye.

Ilaaj ke baad

Soojan, neel aur kuch takleef aam hai aur theek hone mein waqt lagta hai. Aap ka hospital ya urologist zakhm ki dekh bhaal, sargarmiyon, wazan uthane, gaari chalane aur kaam par wapas jane ke baare mein sahi hidayaat dega. Agar aap ka ilaaj embolisation se hua ho to aap ko is chhote se suraakh ki dekh bhaal ka tareeqa bhi bataya jayega.

Mumkina paichidgian

Zyadatar mard theek ho jate hain. Har ilaaj ki tarah masail ho sakte hain. Aap ka urologist faisla karne se pehle aap ke saath khatraat par baat karega.

• Aam: soojan, neel aur kuch der ke liye takleef.
• Kam aam: testicle ke gird pani jama hona (hydrocele), varicocele ka dobara aa jana, ya infection.
• Nadir: testicle ya us ki khoon ki supply ko nuqsan.

Follow-up

Aap ka urologist aam tor par ilaaj ke baad aap ko dekhega taake dekhe ke aap kaise theek ho rahe hain. Agar ilaaj fertility ki wajah se hua tha to semen test kuch waqfe ke baad dobara hota hai, aur aap ka urologist batayega ke kab. Agar soojan barh jaye ya zyada dardnak ho, ya bukhar ho, to jaldi wapas aayen.

Aam sawalaat

What a varicocele is

Blood leaves the testicle through a network of small veins that run up inside the scrotum. A varicocele is when these veins become swollen and twisted, a bit like varicose veins in the leg. It usually happens on the left side, and sometimes on both.

A varicocele is usually harmless. It is not cancer, and it is not an infection.

Please do not be embarrassed. A varicocele is a common reason for seeing a urologist, and many men have one without ever knowing.

How common it is

Varicoceles are common, and they are found most often in teenage boys and young men. Many men find out by chance, for example during a check-up or when fertility is being looked into.

Common symptoms

Many men have no symptoms at all. Others notice:

• A dull ache or heaviness in the scrotum, often worse after standing for a long time or at the end of the day, and better when lying down.
• A soft, lumpy feel above the testicle, a bit like a tangle of small cords.
• A visible swelling in the scrotum, especially when standing.
• A testicle that is a little smaller than the other one.

A varicocele can also be found when a couple is having trouble conceiving.

Why it happens

The veins have tiny valves that keep blood flowing upwards. When these valves do not work well, blood pools in the veins and they swell. It is usually just the way a person's veins are made.

A varicocele is not caused by lifting, cycling, hot weather, exercise, or anything you did in the past. Please do not blame yourself.

A varicocele that appears suddenly, appears only on the right side, or does not shrink when you lie down should be checked by a doctor, because very occasionally another problem is behind it.

Why it can matter

Many men with a varicocele have no problem at all, and not everyone needs treatment. For some men, though, a varicocele can:

• cause discomfort or pain that bothers daily life;
• affect sperm quality, which can make it harder to father a child;
• slow the growth of the testicle, particularly in teenage boys.

Your urologist will help you decide whether any of these apply to you.

How it is diagnosed

Your urologist will usually:

• Ask questions: whether you have symptoms, and whether you and your partner are trying for a baby.
• Examine you standing up, and sometimes while you cough or strain gently, because this makes the veins easier to feel. You may also be checked lying down.
• Arrange a scrotal ultrasound where needed. It is painless, and it shows the veins and the size of the testicles.
• Ask for a semen test (semen analysis) if fertility is a concern. You give a sample, and the laboratory looks at it under a microscope to check the number, movement and shape of the sperm. The laboratory will give you exact instructions on how to give the sample.

Sometimes blood tests are also advised. Your urologist will explain why.

Teenage boys

A varicocele often first shows up around puberty. In most boys it causes no trouble. Because it can sometimes affect how well the testicle grows, a boy with a varicocele should be seen by a doctor, who may check the size of both testicles over time, by examination and sometimes by ultrasound. If the testicle on the affected side is not growing as well as the other, or if it is painful, treatment may be advised.

If your son has a varicocele, please reassure him that it is common and he has done nothing wrong.

Treatment options

Many men do not need any treatment. Treatment is usually considered when there is ongoing pain, when a couple is having trouble conceiving and the semen test is abnormal (after the partner has been checked too), or when a boy's testicle is not growing well. The main options are:

Treatment may improve sperm quality for some men, but it cannot promise a pregnancy, and it does not help everyone. Many things affect fertility, so both partners should be checked.

After treatment

Swelling, bruising and some discomfort are common and take time to settle. Your hospital or urologist will give you exact instructions about wound care, activity, lifting, driving and going back to work. If you were treated by embolisation, you will also be told how to look after the small puncture site.

Possible complications

Most men do well. As with any treatment, problems can happen. Your urologist will talk through the risks with you before you decide.

• Common: swelling, bruising and some discomfort for a while.
• Less common: fluid collecting around the testicle (a hydrocele), the varicocele coming back, or an infection.
• Rare: damage to the testicle or its blood supply.

Follow-up

Your urologist will usually see you after treatment to check how you are healing. If fertility was the reason for treatment, the semen test is repeated after an interval, and your urologist will tell you when. Return earlier if the swelling gets bigger or more painful, or if you have a fever.

Common questions