Among the veins in the structure of the spermatic cord are the veins of the pampiniform plexus, which provide a reverse outflow of blood from the testicle, epididymis, scrotum and become the spermatic vein.
Varicose veins can become dilated and tortuous. Varicocele refers to the expansion of varicose veins. Two other veins also provide venous drainage from the testis, which are usually not included in the process in varicocele disease.
Varicocele – varicose veins of the spermatic cord. Varicocele can cause testicular dysfunction, which occurs in 15-20% of men and 40% of men with infertility. Varicocele can have a detrimental effect on sperm concentration, motility, morphology, and other functions.
Varicocele is most often detected in the left testicle (approximately 80-90%), since there are certain anatomical features:

Stage III – when it is easily detected visually
Stage II – detected by palpation
Stage I – when, in order to identify the patient, the patient strains the stomach and causes
high intra-abdominal pressure, which in turn contributes to the expansion of the veins. This
method is performed by both palpation and sonography and is called the Valsalva
maneuver.

There are several theories as to how varicocele affects sperm quality, but of these theories, only heat is widely accepted.
The temperature in the scrotum is 2-3°C lower than body temperature, since the testicles require a lower temperature (34°C) to produce sperm compared to normal body temperature (36.6°C). In patients with varicocele, the temperature of the scrotum changes and becomes
equal to normal body temperature in an expanded venous network, which causes a violation of the quality of sperm, and in the later stages – testicular atrophy.
In those people who use a laptop – in a sitting state and a laptop on their feet, there is an increase in scrotal temperature. For this reason, it is not recommended to use laptops when placed near the genitals.

Testicular hyperthermia
Most patients with varicocele do not have any symptoms and usually see a doctor for pre-existing infertility. Only 2-10% of men with varicocele experience pain, which is mostly dull, pulling in nature, in some cases, prolonged standing can cause acute pain.
Physical examination is considered the main method for detecting varicocele. With varicocele, during palpation of the spermatic cord, dilated veins are found that look like dilated worm-shaped veins. Physical examination of the pelvic organs should be standard for
urologists, as varicocele can cause significant damage to the testicles, and failure to diagnose can have serious consequences.
Indications for surgical treatment of varicocele are:
Significant discomfort in the testicles, which is not amenable to medical treatment.
Testicular atrophy (volume <20 ml, length <4 cm)
Infertility is caused by a deterioration in the quality of sperm.
A long-term varicocele can cause progressive damage to the testicles, contributing to their atrophy (reduction of the organ, accompanied by a decrease in organ function) and the deterioration of sperm quality.

Varicocele
CARE
Effective drugs for the treatment of varicocele have not been found. Some researchers have proven the effectiveness of food supplements: vitamins A, E, C and B, trace elements: zinc, selenium and copper.

Leydig cell dysfunction due to varicocele in older men can cause a decrease in testosterone, which in turn causes hypogonadism (reduced libido, erection, etc.).

In the case of varicocele, surgery is considered the main method of treatment. The essence of surgical treatment is that the direct venous communication between the testicular vein and the inferior vena cava is interrupted, the reverse flow of blood into the scrotal venous
network of the seed is stopped.