How is varicocele treated?

Written by Chen Feng
Urology
Updated on September 13, 2024
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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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What should I do about varicocele?

The treatment methods for varicocele vary based on the severity of the condition. Clinically, some patients with varicocele show no obvious symptoms and it is only discovered during a physical examination. These patients can generally be observed temporarily, and can also wear tight underwear or use a scrotal support to alleviate the condition. However, some patients do exhibit clear symptoms, such as a significant sensation of heaviness in the scrotum, especially after standing or walking for long periods, where the pain becomes more pronounced. These patients generally need to consider surgical treatment, where the main procedure involves high ligation of the spermatic vein. This can help alleviate symptoms and also improve the quality of semen.

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Written by Zhang Xue Min
Vascular Surgery
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What are the dangers of bruising due to varicose vein rupture?

When varicose veins rupture and cause bruising, if the area is small, it may be absorbed on its own. If the area is large, or if there is a certain degree of fluid accumulation, this fluid can potentially lead to infection, especially if the patient has diabetes or is using steroids, which may cause the accumulated blood to become infected. Additionally, after the absorption of a bruise, some patients may experience local pigmentation. This occurs because the iron-containing hemoglobin from metabolized red blood cells remains in the area, leading to a change in color. In severe cases, if the discoloration recurs, it may darken, and further development in some people might result in the skin becoming rougher and potentially ulcerating.

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Written by Zhang Xue Min
Vascular Surgery
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Does Grade II varicose veins require surgery?

In our clinical staging, Grade 2 varicose veins are the most common type of varicose veins. Often, these do not have complications and are relatively early-stage. The decision to undergo surgery depends on the patient's personal treatment preference. Some individuals might be motivated by cosmetic reasons, such as wanting to wear skirts or shorts in the summer to show off their legs. In such cases, their desire for treatment might be stronger. For some older individuals, they might not care as much, so the choice of undergoing surgery or opting for conservative treatment for Grade 2 varicose veins really depends on the patient's own wishes.

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Written by Zhang Xue Min
Vascular Surgery
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What happens if varicose veins worsen?

Varicose veins, when they worsen, can lead to changes in the skin, including thickening of the skin which feels woody to the touch. Additionally, the skin may exhibit pigmentation that can be severe enough to resemble the black color of a belt. More seriously, ulcers can develop, typically near the inner ankle, though they occasionally appear in other locations. These ulcers are referred to medically as “boot ulcers” and are commonly known among the general population as “continuous sore legs.” In extreme cases, these ulcers may persist for many years without healing and could potentially become malignant.

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Written by Zhang Xue Min
Vascular Surgery
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How to treat varicose veins stage II?

If you're referring to the second stage of varicose veins, I'm not sure if you mean the clinical manifestation stage two, or if it's a recurrence after one surgery. Let's first talk about stage two varicose veins, which means there are visible and tortuous vein clumps. There are several main treatment methods for this condition: First, conservative treatment, which involves wearing medical compression stockings. If symptoms include soreness, heaviness, or cramping, some medications can be taken orally. Then, if there is a desire for surgical treatment, options like vein stripping, radiofrequency, or laser treatments are available. Some may involve sclerotherapy or another method called venous angle keratin treatment, specifically for stage two varicose veins. If it's a recurrence of varicose veins, we need to assess the specific situation. Some people might have had previous endovenous closure surgeries, and their veins are still present. In such cases, we can choose to redo the closure or opt for surgery to remove them. Another scenario is if the varicose veins have recurred after surgery. We need to investigate the cause. Some people might have iliac vein stenosis, and in such cases, treatment targeted at the iliac vein is necessary.