What is the structure and function of the testicles?
In men, the testicle is the organ that produces the male hormone (testosterone), which is responsible for the production of sperm (semen) and the development of a man’s body structure and sexual organs. A healthy adult has a pair of testicles that are located inside the sac (scrotum) at the bottom of the penis. It is approximately the size of a walnut and its internal structure is similar to a fig. In order for the sperm produced in the testicle to be ejaculated from the penis, a sperm canal coming out of the testicle is needed. This long thin canal starts from the testicle, goes from the inguen to the abdomen, and then opens with a hole in the urinary canal that runs through the penis. Thus, the sperm produced is ejaculated from the penis through the semen. It also has its own blood vessels that feed the testicles.
What is a varicocele?
Varicocele is a varicose vein expansion of the testicles, similar to the varicose veins seen in the leg, that is, vascular dilations.
What are the effects of varicocele on sperm?
The testicles must be in an environment 1-2 degrees colder than body temperature in order to produce adequate amounts and quality sperm. Therefore, unlike women, male eggs are outside the body, in other words they are inside a sac (scrotum) hanging from the body. In a varicocele, the expanding veins create a pond here and cause the temperature of the testicle to increase. For this reason, men with varicocele have a low sperm count, abnormal sperm form, or decreased motility.
What are the environmental factors affecting sperm?
- 1 Smoking: It decreases sperm count and motility and disrupts the normal structure of the sperm.
- 2 Alcohol: Excessive alcohol intake decreases sperm count and causes abnormal sperm output.
- 3 Testicular temperature: Testicular temperature in men is lower than body temperature. If the testicular temperature increases, sperm production decreases. High fever, working in a hot environment, sauna, and wearing tight pants can increase testicular temperature.
- 4 Overweight: It causes an increase in testicular temperature and a decrease in sperm count.
- 5 Excessive exercise: It may cause infertility by reducing hormone production.
- 6 Medications: Some blood pressure and ulcer medications can lower sperm count and decrease sexual desire.
Does varicocele cause infertility?
Varicocele is a progressive disease and causes regression in testicular development, thus, infertility (inability to have children) by disrupting sperm production. It is mostly seen on the left side, but it can also be seen on both sides. It is one of the most common and treatable causes of male infertility. It is seen in approximately 20% of adult males in society. It is encountered in 60% of men who apply due to the inability to have children.
How is varicocele diagnosed?
Physical examination; The most important method in diagnosis is the examination by an experienced Urologist. In the examination by a urologist, it is investigated whether the testicles are in place, the condition of the testicles, sperm canals, and whether there are dilated veins (varicocele) in the scrotum. In the examination, the degree of varicocele is divided into 3; 1- Mild, 2- Moderate, and 3- Advanced.
Sperm analysis (spermiogram): Varicocele can cause sperm count, movement, and deformity. After 3-5 days of sexual abstinence, the patient is evaluated with a sperm analysis (spermiogram). Ideally, 2 separate spermiograms at least 15 days apart would not be done without a recent illness or infection. If the result of sperm analysis is abnormal, further tests such as hormone analysis and genetic examination may be required.
Scrotal Color Doppler Ultrasonography; The diameters of the veins, whether dirty blood returns to these vessels (reflux), and whether there is volume loss in the testicle are all studied with this examination.
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