The difference between thromboangiitis obliterans and varicose veins

Written by Zhang Xue Min
Vascular Surgery
Updated on January 01, 2025
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Firstly, these are two completely different diseases. Thromboangiitis obliterans is an inflammatory vascular disease involving the medium and small veins and arteries, causing migratory superficial phlebitis and leading to the obstruction of the veins, as well as some obstructions in the lower limb arteries. Thus, thromboangiitis obliterans includes some obliterative diseases of both arteries and veins, the cause of which is an autoimmune inflammation.

Varicose veins are one of the most common vascular surgical diseases. They primarily manifest as tortuous, clustered, and dilated superficial veins of the lower limbs. This condition does not involve arterial changes, but varicose veins can progressively worsen and may lead to pigmentation and ulceration, which at that time necessitates differentiation from arterial ulcers. Generally, the ulceration in varicose veins is located in the "gaiter area," which is the area covered by a boot when wearing one, including the lower one-half to one-third of the lower leg. Most of the ulcers from varicose veins primarily appear above the inner ankle.

The ischemia caused by thromboangiitis obliterans leads to a dry-type ischemia, where the limbs can gradually become dry, shriveled, atrophied, and blackened, with ulcers typically beginning from the extremities.

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Written by Chen Feng
Urology
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How is varicocele treated?

The treatment of varicocele depends on the severity of the condition. Clinically, some varicocele patients do not exhibit obvious symptoms, or show no symptoms at all and are only diagnosed during physical examinations. These patients can generally be treated conservatively by avoiding standing for long periods, avoiding prolonged walking, and by wearing tight underwear to alleviate symptoms of varicocele. However, some patients with varicocele do exhibit clear symptoms, including discomfort and pain in the scrotum on the affected side, especially after long periods of walking. These symptoms can become more severe and may also be accompanied by abnormalities in semen quality. These patients generally require surgical intervention, such as high ligation of the veins.

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Written by Chen Feng
Urology
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Can varicocele heal itself?

Varicocele generally cannot be cured, and most patients with varicocele do not have any symptoms and only discover their condition during physical examinations. Such patients can temporarily be under observation, but they should regularly have their varicocele rechecked and also have their semen quality tested. If there are abnormalities in semen quality, timely surgical treatment is necessary. Clinically, a small number of varicocele patients exhibit significant symptoms, typically presenting as discomfort and pain on the affected side of the scrotum, especially after long periods of walking or standing, with pain becoming more pronounced. In such cases, prompt surgical intervention is generally necessary, and surgery can also improve the quality of the patient's semen.

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Written by Wang Shuai
Urology
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Causes of varicocele

There are several causes of varicocele, including congenital factors and secondary causes. Congenital causes are mainly seen in cases of incomplete development of venous valves, while secondary causes may result from prolonged sitting, standing, or intense exercise over time. Some patients develop varicocele due to kidney tumors or blood clots in renal veins, which obstruct the blood flow returning through the spermatic vein. Patients with severe varicocele may experience a sensation of heaviness and pain in the testicles. In treating varicocele, it is also important to understand the reasons behind it. If it is caused by a tumor, active treatment of the tumor is necessary.

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Written by Wang Shuai
Urology
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Can bilateral varicocele be cured?

After the occurrence of varicocele, some patients may experience a feeling of heaviness and pain in the scrotum, which is often more apparent after prolonged standing, sitting, or intense exercise, and gradually alleviates after lying down and resting. During physical examination, tortuous veins similar to earthworms can be felt inside the scrotum. A color Doppler ultrasound examination is needed for further clarification. For bilateral varicoceles, it is currently curable. The main treatment method is surgical intervention, such as laparoscopic high ligation of the spermatic veins on both sides. This surgical approach is a minimally invasive procedure and the surgical outcomes are quite definite. Generally, a recovery period of 3-6 months after surgery is expected before complete recovery.

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Written by Zhang Xue Min
Vascular Surgery
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Will wearing compression stockings every day help with Grade 2 varicose veins?

In the grading of varicose veins, Grade II signifies that there are obvious superficial vein tortuosity and dilation, and some may even clump together, but without edema and pigmentation. For patients with such newly developed varicose veins, persisting in wearing compression stockings can possibly lead to improvement. The main principle here is that in patients with newly developed Grade II varicose veins, the damage to the venous valves may not be severe, but rather due to venous pressure causing vein dilation, resulting in the valves not closing tightly. In such cases, if we apply external force to ensure the valves close tightly, preventing further vascular dilation and reducing the force of damage to the valves, then there is a possibility of recovery to a certain extent. If the condition has been present for a longer time, and this valvular dilation has already resulted in long-term effects, wearing compression stockings might only help in reducing the potential for further progression, but it is unlikely to improve existing varicose veins significantly.