Pelvic pain
It is most often associated with the following problems:
Infertility has been mentioned in many conversations with friends and in the media lately. One of its causes may be varicocele. What other health risks are associated with it?
What is a varicocele?
Simply put, it is a varicose vein in the loose skin sac that holds the testicles. The veins in this area become enlarged, which can lead to reduced sperm production or even infertility. A varicocele can cause the testicles to shrink or fail to develop properly. The good news is that it can be easily diagnosed and treated with a relatively quick surgery.
Causes of varicocele
The exact cause is not scientifically confirmed, but it is likely related to:
- rapid development/growth of the genitals during puberty,
- improperly functioning vein valves in the spinal cord, which disrupts blood flow and leads to dilation of the veins,
- swelling of the lymph nodes.
What causes untreated varicocele and what are its symptoms?
Varicocele is often not noticed by men because it occurs without symptoms. If any symptoms appear, they are usually testicular pain when standing or during physical exertion. This pain subsides if the man lies on his back. Another prominent symptom is increased temperature of the testicles and increased sweating in the area. Since these are varicose veins, visible thickened and twisted veins are also a symptom.
Untreated varicocele can lead to these three problems:
- Problems with the development and function of the testicles – the testicles can atrophy, meaning they shrink and soften.
- Testicular pain – usually occurs on the left side and is likely due to the location of the left testicular vein. It is usually sharp, sometimes feels like a strong pressure, and is relieved by lying down. Along with the pain, swelling of the left side of the testicles may also occur.
- Infertility – impaired blood flow to the testicles as well as their atrophy and softening can lead to reduced sperm production and thus male infertility.
Diagnosis and subsequent surgery for varicocele
Diagnosis
A urologist can diagnose varicocele. Based on the symptoms and general health, it is relatively easy to determine whether a man has this problem. The examination consists of palpating the testicles, as the enlarged veins can be felt during palpation. The doctor also checks the softness of the scrotum to exclude or confirm its atrophy. If the diagnosis is not possible based on the appearance and palpation of the testicles alone, modern imaging methods are also used, especially ultrasonography, but also tomography or Doppler diagnostics.
The so-called Valsalva maneuver is also used during the examination. The man takes a deep breath while standing and holds his breath, while tensing his abdomen and pelvic muscles as if he were having a bowel movement. Then he exhales sharply. This causes changes in the testicles that the doctor can easily notice.
The last diagnostic method is a spermiogram, which measures the amount of sperm in the ejaculate. This examination is important for determining male infertility.
Microsurgical operation for varicocele
This is the most gentle treatment for varicocele, which only leaves a small wound. Microsurgical operation for varicocele is performed under an operating microscope, which allows even the smallest veins to be captured well. You don’t have to worry about pain either – the procedure is performed under general anesthesia. It is most often performed in the morning, on an empty stomach, and the patient can go home in the evening. The wound is then treated with disinfectants and bandaged regularly. During the operation, problematic veins are interrupted or tied. The wound (in the groin area) is then sutured and an anesthetic is applied to the area to numb it and prevent the patient from experiencing pain upon waking. After the operation, the patient is monitored for the next five hours. He should go home accompanied by another person and is not allowed to drive a car for 24 hours.
Chronic prostatitis causes pelvic floor pain, difficulty urinating, and is sometimes accompanied by elevated body temperature and problems with sexual life. It is not only a disease of older men but also of younger age groups.
There are several forms of prostatitis: 1. Acute bacterial prostatitis. It is caused by bacteria and is manifested by acute symptoms: Chills and fever, pain in the lower back, lower abdomen, perineum, burning during urination and inability to urinate. 2. Chronic bacterial prostatitis is also caused by bacteria, but has a long course. Its symptoms are pain in the lower abdomen and perineum, occasional burning during urination, lack of interest in sex and often erectile dysfunction. 3. Chronic pelvic pain syndrome is the most common form of prostatitis. It has a long course, but without the presence of infection. It can be inflammatory or non-inflammatory. It manifests itself similarly to chronic bacterial prostatitis: Pain in the perineum, in the testicles, in the penis and in the bladder area, pain during urination and ejaculation. The disease has periods of improvement and deterioration. 4. Asymptomatic inflammatory prostatitis is an asymptomatic disease that is discovered incidentally during a urological examination or prostate biopsy.
Diagnosis of prostatitis involves a thorough history, examination of urine, prostate secretions, ejaculate, palpation of the prostate, and ultrasound examination.
Treatment of prostatitis involves the use of antibiotics / in the case of bacterial prostatitis /, nonsteroidal analgesics, alpha-blockers, herbal preparations, antimuscarinics, and heat application. A highly effective method of treating chronic prostatitis is ESWT / shock wave therapy /. Chronic prostatitis and chronic pelvic pain syndrome are optimal indications for shock wave therapy. The ESWT method consists of applying extracorporeal shock waves to calcified prostate scars, to which bacteria adhere. The effect of the shock wave destroys calcifications, which are phagocytized by leukocytes and subsequently more easily eliminated by the body’s own immune system. The treatment is outpatient, does not require hospitalization. The patient undergoes a series of at least 4 sessions with us, once every one to two weeks.
