Varicocele
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Varicocele is a disease manifested by pathological dilatation of the veins of the pampiniform plexus. This is the most common cause of the male infertility. This pathology occurs among 4-8% of men, most of them (approximately 80%) do not have any complaints. Varicocele is more often diagnosed at the age of 15-25 years. The disease requires surgical treatment. In most cases, the aim is to maintain or restore male reproductive function.
The Booking Health portal presents 70 German clinics specializing in varicocele treatment
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Varicocele – Diagnostics
In the most cases it is possible to establish the diagnosis with the help of the physical examination. Varicose veins of the pampiniform plexus are easily palpated. The easiest way to identify the disease is to carry out the examination when patient stands in an upright position and strains (pelvic muscle tension). In case of mild varicocele, in the horizontal position the veins can become invisible.
The following instrumental and laboratory methods can be used for diagnostics:
- Selective phleborenotesticulography, tonometry, duplex scanning. The retroperitoneal vessels are examined and their diameter is determined. The blood flow velocity is estimated, pressure in the left renal vein (normally it does not reach 10 mm Hg) is also measured. Instrumental diagnostics is necessary to determine severity of a varicocele, as well as its cause.
- Semen analysis and MAR-test are used to assess men's reproductive function. Quality and quantity of semen are analyzed. MAR-test is carried out in the framework of extended semen analysis. It is aimed at the diagnostics of immunological infertility. This diagnosis is established in the case of a large number of sperm antibodies attached to spermatozoa.
Best clinics for the varicocele diagnostics in Germany:
Varicocele – Treatment
Varicocele can only be treated with the help of surgery. Indications for surgical treatment in Germany include:
- Pain in the scrotum which violates the man’s quality of life
- Testicular atrophy
- Infertility, in the case when a man plans to have children in the future
Several groups of surgeries are performed to restore the normal blood flow:
Excision or ligation (bandaging) of the testicular vessels. Both open and laparoscopic surgeries can be applied.
Endovascular interventions. Operations are carried out with access through the blood vessels under the X-ray control. The purpose of the surgery is the occlusion (blockage) of the blood vessel with the cessation of blood flow through it.
Different types of the operations are used during treatment in Germany, such as:
- Transfemoral retrograde sclerotherapy. An agent that damages the endothelium is injected into the vessel. As a result, vessel walls fuse together and the blood flow through it ceases.
- Embolization of different types – balloon, spirals, combined.
- Occlusion with the help of physical methods – electrocautery (burning), usage of the hot contrast fluid.
Creation of vascular anastomoses. Microsurgical interventions are carried out for the creation of additional artificial venous outflow tracts from the testicle. The choice of a surgery is based on the characteristics of the disease, and the economic feasibility.
In the case of left-sided varicocele (most cases of the disease) endovascular techniques are usually performed because they are inexpensive, less invasive and do not require long-term rehabilitation.
In the case of right-sided varicocele, open surgeries are performed, as in this case, the normal process of blood flow recovery is more complicated.
Laparoscopic interventions are the most expensive techniques, so they are mainly performed in case of the bilateral varicocele treatment. Microsurgical procedures for the formation of the vascular anastomosis are used for severe hypertension in the renal vein (in case of the bilateral varicocele) treatment.
Best clinics for the varicocele treatment in Germany:
Varicocele – Rehabilitation
During the first days after surgical treatment in Germany men wear suspensory. This is a special bandage that protects the scrotum from physical influences and shaking when walking. The bed rest is recommended for the patient. If necessary, painkillers are prescribed. After 7-10 days, the period of active rehabilitation begins after the healing of the postoperative sutures.
The most modern rehabilitation programs are used in Germany. They are adapted individually for each patient, and are based on the treatment methods, age, and physical possibilities. Different specialists such as: therapists, surgeons, psychologists, physiotherapists are involved in the rehabilitation process.
The following methods of rehabilitation are used:
- Dosed physical activity
- Training on the simulators and in the pool
- Physiotherapy
- Acupuncture
- Massage and other relaxing techniques
The rehabilitation includes the medicamentous support in order to improve the state of vessels and prevent recurrence of the disease. It is necessary to hold a consultation with the patient about the proper nutrition and the way of life which is important for him in the current situation (it is necessary to exclude weight lifting, strength sports trainings, etc.).
Rehabilitation programs in Germany are designed for 2 weeks. If necessary, they can last much longer. In this country, the patient is provided with qualitative care, accommodation in comfortable rooms and individually selected meals.
Rehabilitation programs in Germany show one of the best results in the world. Most patients successfully restore their employability and excellent health there. They remain physically active, return to the full social and family life.
Best clinics for general therapeutic rehabilitation in Germany:
Author:
The article was edited by medical expert, board certified Dr. Nadezhda Ivanisova. For the treatment of the conditions referred to in the article you must consult a doctor; the information in the article is not intended for self-medication!
Sources:
IMTJ - International Medical Travel Journal
The cost of services includes
Here you can find the cost of treatment for this disease at the German University Hospitals. Leave a request and we will provide a free consultation with a doctor and will start organizing the whole treatment process.
The program includes the following:
- Issuing of an invitation for getting a visa for treatment as quick as possible
- Fixing an appointment at a time convenient for you
- Preliminary organization of a comprehensive examination and discussion of the forthcoming treatment plan
- Arranging transfer from the airport to the hospital and back to the airport
- Provision of interpreting services and services of a personal medical coordinator
- If necessary, assistance in the organization of further surgical treatment
- Provision of a medical insurance against treatment complications covering up to 200,000 euro
- Preparation and translation of medical records and recommendations from the hospital
- Assistance in the subsequent communication with your attending physician, including consultations on repeated X-ray images through the unique medical document management system E-doc
