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Features of a varicocele of the 2nd degree: a photo of the disease in men and whether surgery is needed when located on the left?

Varicocele is an expansion of the veins of the testicle, which entails a malfunction in the gonads in men. The disease proceeds in 4 degrees. At the initial stage, the symptomatology does not manifest itself, so often patients notice changes when a varicocele of 2 degrees occurs.

In the article we will tell:


Varicocele 2 degrees called the intermediate stage. You can notice the development of the disease at this stage, since the patient begins to feel some discomfort in the inguinal region. Often men complain about the manifestation of pain in the scrotum.

In this case, the pain can be different and may depend on the specific situation. For example, often pain occurs only during physical activity. In addition to pain, a burning sensation, excessive sweating, and dysfunction are sometimes observed.

What is this diagnosis?

According to medical statistics, varicocele is more common in adolescents and young people. In more rare cases, pathology is found in children and adult men.

Usually one (most often left) testicle is affected. Only in 2% of cases, bilateral varicocele is detected.

The disease itself is not dangerous, many patients live with her for many years without resorting to treatment.

However, complications arising from varicocele cause a lot of trouble, from too early ejaculation and discomfort when urinating to male infertility.

In the initial stage, the disease is difficult to identify. Veins almost do not change appearance, blood flow worsens, but does not affect the patient's condition.

Anxiety occurs when a varicocele of the 2nd degree occurs. At that time the affected veins swell around the testicle with a noticeable bluish net. The left testicle is usually affected, but there is also a right-sided or even bilateral varicocele.

With further development, the symptoms intensify, the patient feels pain, swelling and inflammation are possible. The scrotum sags, the affected testicle grows in size and becomes denser. Varicocele stage 2 is characterized by a variety of complications.

Varicocele 2 degrees: photo in men

Photo varicocele 2 degrees left


The main cause of grade 2 varicocele is the malfunctioning of venous valves. With increased blood flow, the outflow slows down, internal pressure rises, the walls of the vessels become deformed, clearly protruding under the skin.

Such a pathology may occur as a result of:

  • hereditary predisposition to varicose veins,
  • chronic constipation
  • neoplasms in the area of ​​the vaginal plexus, infringing and deforming vessels,
  • congenital pathology of the renal vein and mesenteric artery,
  • obesity or a significant excess of the normal body mass index,
  • weight lifting or strength sports,
  • groin injuries
  • chronic cardiovascular disease,
  • irregular sex life
  • inflammatory processes of the pelvic organs.

I would also like to note that most often you can meet patients with varicocele 2 degrees on the left.

Characteristic symptoms

Urologists note that varicocele is not characterized by rapid progression. Usually the disease stops at 1 or 2 stages for a sufficiently long time. Most often, the patient goes to the doctor in phase 2.

For varicocele 2 degrees, the following symptoms are characteristic:

  • increased venous plexus,
  • pain after short-term stress, going to the toilet, hot bath or sexual intercourse,
  • unpleasant pulling sensations in the lower abdomen,
  • early ejaculation
  • increased sweating
  • short-term temperature increase,
  • an increase in the size of the scrotum and its sagging,
  • change in testicle shape (increase or decrease),
  • a feeling of heaviness and burning in the scrotum.

If untreated, the disease becomes chronic, which is characterized by alternating exacerbations and remissions.

It will not be superfluous to mention that the symptoms of varicocele 2, 3 degrees are very similar, therefore, if the slightest hint of this disease is detected, we advise you to seek help from a specialist.

Features of a varicocele of the 2nd degree: a photo of the disease in men and whether surgery is needed when located on the left?

Varicocele is a benign pathology associated with varicose veins in the area of ​​the vaginal plexus.

At the beginning of the disease, the patient almost does not feel discomfort, however, with the development of the process, pain and a feeling of heaviness can occur.

The interlacing of veins changes the appearance of the testicle, the scrotum sags and causes inconvenience.

All these signs are characteristic for stage 2 - it is at this time that intensive treatment usually begins.

Varicocele of the second stage

With varicocele 2 degrees, the patient has complaints of pulling pain in the scrotum. Visually determined expansion of the saphenous veins and significant swelling of the affected testicle. The disease occurs due to congenital malformations of the structure of the connective tissue or violation of the topography of the venous channel of the scrotum. Trauma can also provoke the development of the disease.

Varicocele often occurs on the left.

Reasons for development

The second stage of varicocele in men occurs as a result of the influence of such factors:

  • congenital malformations of the structure of the connective tissue, which forms valves in the veins that impede the reverse flow of blood,
  • incorrect location of the venous vascular network,
  • scrotal vascular injury,
  • high pressure in the venous sinus of the pelvis,
  • kidney tumor
  • weight lifting
  • frequent constipation or diarrhea,
  • playing sports
  • bad habits.

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How to recognize

With varicocele of the second degree, the patient complains of constant pain in the affected testicle, which intensifies after exercise or a long standing position. The nature of the pain ranges from aching and oppressive to sharp lumbago, giving in the groin. Visually noticeable swelling of the scrotum and an increase in the diseased testicle due to stagnation of blood. The trophic genitalia of a man suffers. The skin on the scrotum changes to turn purple, and the hair falls out. It is clearly visible expansion of the saphenous veins, which increases in a standing position.


Varicocele of the 2nd degree of the left testicle occurs much more often than the right and with a long course leads to the development of severe trophic disorders of the genital organs of men. Stagnation of blood and the resulting swelling provokes constant pain and the inability to perform sexual function. With a long course, the disease leads to impaired erectile function in the patient due to insufficient production of male sex hormones. Violation of the temperature of the testes affects the quantity and quality of sperm. A patient with varicocele develops non-viable sperm and infertility develops.

Diagnostic procedures

You can suspect a varicocele during an external examination of the patient and presenting them with complaints of unpleasant sensations in the testicle. It is possible to confirm the diagnosis with the help of ultrasound with dopplerography, which helps to visualize the state of the vascular bed and detect their expansion. It is recommended to take a general blood and urine test, as well as conduct a spermogram, which determines the number of living and moving male germ cells. In case of difficulties in the diagnosis, the use of magnetic resonance imaging and computed tomography is shown.

Treatment methods for varicocele in 2 degrees

Therapy of varicocele in the second stage of development consists in the removal or sclerosis of the altered testicular veins. For this, various surgical techniques are used. The choice of one of them depends on the characteristics of the course of the disease in a particular patient. After the operation, the patient needs a long recovery period. At this time, the use of various medications is indicated. In the process of complex therapy, the use of non-traditional methods is possible. Herbal medicine with the use of herbs that relieve inflammation and eliminate trophic disorders has become widespread among traditional medicine.

It is impossible to get rid of varicocele in the second stage of development without surgery.

Drug treatment

During rehabilitation, the patient is shown the use of phlebotonics, normalizing vascular tone. And also used antiplatelet agents and anticoagulants. They prevent the formation of blood clots in the altered vessels and prevent the development of complications in the form of heart attacks or strokes. In addition, vitamin-mineral complexes are used, which accelerate the process of patient rehabilitation after an illness.


Surgery is the only way to treat varicocele. However, there are a variety of methods for surgical intervention. The choice of one technique depends on the particular course of the disease in a particular patient, as well as on the presence of contraindications and concomitant pathology. Microsurgical treatment is considered the least traumatic, in which coagulation and sealing of veins is carried out with their subsequent thrombosis. Possible methods of endoscopy with the removal of altered veins, as well as open approaches with excision of the venous bed.

How to prevent?

Prevention of varicocele 2 stages of development is the rejection of bad habits, the fight against constipation and other factors that can trigger an increase in pressure in the pelvis. Before surgery, wearing supportive clothing is recommended, which will prevent the dangerous effects of the disease. And after carrying out surgical manipulation, it is important to start running and swimming, because they will help keep the vessels in good shape.

Diagnostic methods in men

Men at risk should visit the urologist annually. Timely diagnosis will help to start treatment on time.

  1. The specialist will conduct a general visual examination, allowing you to notice the strengthening of the venous network and changes in the appearance of the scrotum.
  2. On palpation, the doctor will determine the condition of the veins, the shape and size of the affected testicle and its difference from a healthy one.
  3. An ultrasound examination will help confirm the diagnosis and accurately determine the phase of the disease.
  4. Dopplerography is used to clarify the condition of the veins. With its help, you can determine the intensity of blood flow and reverse blood reflux, check the elasticity and permeability of the walls of blood vessels.
  5. If infertility is suspected, a spermogram is taken from the patient, it will help identify functional testicular disorders.

Now that you have learned a little more about the disease of varicocele 2 degrees, treatment is the next topic that we will talk about in this article.

Treatment options

With stage 2 disease, conservative treatment is possible. The patient is prescribed venotonics that improve the condition of the veins.

Anticoagulants that improve blood flow and prevent thrombosis are also useful. Preparations in the form of tablets or capsules can be used for 2-3 weeks in a row, followed by a break.

Among the most effective means are Detralex, Phlebodia, Venarus. For pain attacks, analgesics, anticonvulsants, or first-generation antidepressants are used.

Ointments with anesthetics will help to remove painful swelling, burning and itching.

If the patient suffers from chronic constipation, soft laxatives based on lactulose, which do not irritate the intestinal wall, are used.

Glycerin suppositories can be used as express agentsthat do not violate the natural intestinal microflora. These methods are good for self-treatment of varicocele 2 degrees.

Is an operation necessary?

The second stage of varicocele is the perfect time for surgery. Only surgical intervention can radically correct venous pathology and improve the well-being of the patient.

With the 2nd phase of the disease, all symptoms manifest themselves quite clearly, while the patient’s body is not weakened and quickly recovers after the intervention.

    Most often, the patient is recommended one of the gentle minimally invasive techniques. Endoscopy shows good results.

The affected areas of the veins are removed under the control of the endoscope, the operation is performed under local anesthesia and does not require extensive incisions. The method allows to avoid complications, the patient recovers after 3-4 days.
If there is no risk of thrombosis, the patient may be prescribed sclerotherapy.

Using a curved needle, a gluing agent is injected into the affected veins, causing them to quickly become infected with collagen fibers. Blood flow decreases, internal pressure drops, and the patient feels better.
Another option is the classic excision of veins with a scalpel. During an operation under general anesthesia, an incision is made on the scrotum.

Deformed vessels are removed through it, the edges of the wound are sutured with self-absorbable threads, the suture is covered with a sterile dressing.

The operation does not impair fertility, but requires a long recovery (at least 3-4 weeks).

Possible complications:

  • dropsy of the testicle
  • local edema,
  • pain with scrotum.

Typically, these manifestations disappear by the end of the recovery period without additional treatment.

How to stop the development of the disease?

So that the second stage of the varicocele does not go into the third, all provoking factors must be excluded from the patient’s life. Proper nutrition is very important. It is necessary to exclude spicy and fatty dishes that badly affect the state of the vessels.

Preferably refuse red meat, replacing it with fish and poultry. Spices, smoked meats, pickles, canned foods can provoke veins expansion. It is better not to salt food using more products containing natural sodium: green vegetables, tomatoes, root crops.

It is very important to avoid constipation. Any strong tension causes blood flow to the affected veins, which provokes the development of the disease. It is important to include foods rich in dietary fiber in the menu, drink more, refuse caffeine and animal fats.

Any pathology associated with the expansion of veins requires a complete rejection of bad habits. A patient with varicocele should completely exclude alcohol, including beer and low alcohol cocktails.

Nicotine and tobacco tar increase the fragility of the vascular walls and provoke their deformation, slowing blood flow. In addition, smoking can threaten with thrombosis, which is fraught with exacerbations and even infertility.

Moderate locomotor activity without overvoltage will help improve venous tone. Useful exercises at home or in the gym, jogging, walking, swimming, skiing. Strength sports that adversely affect the affected vessels should be avoided.

The second stage of varicocele is the most suitable moment for surgery. A timely operation improves the patient's condition, completely solves aesthetic problems, and removes the risk of infertility. Subject to the recovery regime, there will be no relapse of the disease.

Is an operation necessary for varicocele 2 degrees?

Genetic, physiological factors, inflammatory diseases of the pelvic organs, and mechanical injuries lead to varicose veins in the scrotum. Adolescents and young men are more prone to this pathology. The onset of the disease in most cases goes unnoticed.Clinical symptoms are characteristic of a varicocele of the second degree - a progressive state with a pronounced violation of the outflow of blood from the testicular veins.

The mechanism and causes of the formation of pathology

Varicocele is a chronic violation of blood flow through the veins of the papillary plexus of the spermatic cord. It provokes a weakening of the venous valves, which should normally prevent reflux - reverse blood reflux. As a result, stagnation occurs, the walls of the vessels are stretched. At first, this happens sporadically: when walking, running, and physical activity. Over time, the disease progresses - varicose nodes form in the affected areas, pain appears and intensifies. The left testicle suffers more often due to the peculiarities of the blood supply to the testicles. In complex cases, a two-way process develops.

Varicocele does not pose a threat to life, but can significantly complicate it. In the advanced stages, the pathology is painfully tolerated, leading to a decrease in the size of the diseased testicle, deformation of the scrotum, impaired spermatogenesis and infertility.

Most researchers are inclined to conclude that intrauterine disorders are the main causes of the development of the primary, so-called idiopathic, varicocele. In the future, incorrect formation of the inferior vena cava or renal veins, and malformations of the connective tissue can lead to the disease.

The provoking factors of varicose veins of testicular vessels are:

  • increase in abdominal pressure,
  • insufficient heart valve activity,
  • flat feet
  • chronic kidney disease
  • anatomical abnormalities: different lengths of testicular veins, weak walls of blood vessels,
  • mechanical compression of the spermatic cord by a hernia or neoplasm.

Often, varicocele originates in adolescence, without showing itself for a long time. Pathology begins to progress under the influence of both internal and external factors:

  • regular and prolonged standing
  • a ride on the bicycle,
  • wearing tight belts
  • regular constipation.

The impetus for the development of secondary varicocele can be injuries of the inguinal region, complications after operations, triggered by STDs.

According to the classification adopted by WHO, there are several degrees of varicocele, which are the stages of the disease:

  • first - vein expansion is insignificant, occurs periodically under the influence of physical activity, is not detected by palpation, nodes are absent,
  • the second - extended areas are determined by touch, there are clinical symptoms of the disease, external changes in the scrotum may appear,
  • third - varicose nodes are clearly visible externally, the scrotum is deformed, severe pain persists at rest.

Diagnosis of the disease

Varicocele of the second and third degree usually does not cause difficulties in diagnosis. The phlebologist determines the presence of pathology by palpation, asking the patient to strain the abdominal muscles in a standing and lying position. The affected areas of the venous plexus harden and are well felt.

To determine the nature of the disease, the patient is questioned, finding out the nature of the symptoms, the presence of concomitant disorders, previous injuries.

Varicocele of the second stage on the left often indicates the primary nature of the disease, a bilateral or right-sided process - a symptomatic origin due to other pathologies.

Instrumental and laboratory studies:

  1. to confirm or exclude provoking diseases and to clarify the degree of damage to testicular veins, ultrasound of the testicles, kidneys and retroperitoneal space is prescribed,
  2. probable vascular thrombosis is detected by computed tomography or MRI,
  3. to identify abnormalities in the structure of blood vessels, an additional contrast testicular and renal venography is performed,
  4. patients who have reached the age of 18 are prescribed an ejaculate analysis. By changing the spermogram, the neglect of varicocele is judged. Negative signs: a large number of weakened or dead sperm.

Treatment and prognosis

The second degree of varicocele is progressive, it is impossible to cure it with completely conservative methods. Medications and physiotherapy help temporarily ease the symptoms, but do not affect the structure of the altered vessels.

Therapy is justified in preparing the patient for surgical treatment and in cases where immediate surgical intervention is not possible.

With secondary varicocele, it is necessary to treat the underlying disease.

To improve blood flow, the patient is prescribed venotonics and vitamins: Detralex, Venarus, Ascorutin, drugs with antioxidants, antiplatelet agents. Pain is relieved by NSAIDs, analgesic injections. Additionally, drugs are prescribed to regulate the functioning of the intestine, to prevent constipation and diarrhea.

Significantly and permanently relieve physical condition, restore normal blood supply and avoid further problems in the reproductive sphere, only surgical intervention helps.

With varicocele of the second degree, gentle minimally invasive techniques are applicable:

  • laparoscopic varicocelectomy - after a few punctures in the abdominal wall, tools are introduced and the varicose nodes of the vascular bundle of the scrotum are ligated,
  • endovascular sclerosis - a catheter is inserted through an incision in the thigh, through which a substance gluing the nodes is delivered to the affected vein,
  • microsurgical ligation of veins according to Marmar - through a small incision in the area of ​​the inguinal ring, the doctor gains access to the diseased areas of the veins, excises them and bandages them.

In the case of secondary varicocele, complicated by impaired renal veins, vascular thrombosis, an open abdominal operation is used according to Ivanissevich, Bernardi.

After surgical treatment, the likelihood of recurrence of varicocele is 15-30%.

It is pointless to resort to the help of various folk remedies for a disease in the second stage. Changes in the structure of blood vessels are irreversible. Venous nodes are unable to resolve.

Determination of the degree of varicocele

Varicose veins are considered a common disease in urological practice. As a rule, the disease forms on the left of the scrotum, however, there are cases when a varicocele affects both sides of the organ. Pathology is accompanied with diseases such as flat feet, phimosis, heart valve disease and varicose veins of the extremities.

For information! Varicocele 1 degree is not able to cause inconvenience to a man. The intensity of the symptoms depends on the degree of extensibility of the veins.

Varicocele is classified into 4 degrees, an important point is the timely diagnosis of the disease and proper treatment. The consequence of a neglected disease manifests itself in the form of infertility and enlargement of the penis. Consider the main degrees of varicocele in a man:

  • Varicocele 1 degree on the left - this stage is considered hidden, the disease can not be visually determined or felt, and as a rule, 1 degree of vein expansion occurs without symptoms. This stage is determined using ultrasound or dopplerography. Most often, varicocele of the 1st degree does not pay due attention to what can cause the progression of the disease up to the fourth stage,
  • Varicocele 2 degrees on the left - this stage is determined in the standing position of the patient or during physical exertion. At this stage, it is recommended to diagnose and pass a spermogram analysis. The second degree of the disease indicates the development and presence of varicocele,

For information! Varicose veins arise as a result of structural features of the left part of the renal vein, weak walls and high pressure in the inguinal region.

  • Varicocele on the left 3 degrees - this stage is determined in any position, the man complains of periodic pain in the scrotum. In the process of palpation, enlarged veins are felt. Grade 3 varicocele involves an increase in the scrotum and left testicle. 3rd degree involves ultrasound, doppler and sperm analysis,
  • Grade 4 - at this stage, signs of pathology can be determined during a routine examination. A man experiences frequent pain inside the vein of the testis and spermatic cord, resulting in infertility.

Indications for surgery

Surgical intervention can be applied at any stage. You can operate only after passing the necessary tests and passing the diagnosis. Does a varicocele of the 1st degree need an operation? Depending on the development of the disease, the urologist can prescribe surgery, as a rule, surgery is needed if the man is at risk of infertility. At 1 degree of the disease prescribed:

  • Operations according to the method of Ivanissevich - with its help they perform punctures and remove or bandage the vein,
  • Sclerosis of the veins - with its help, a puncture is made in the groin area, a catheter is inserted and it is filled with a special liquid that stops the blood flow,
  • Endoscopic surgery - performed using a puncture, into which an endoscope is inserted and a vein is ligated.

For information! At 1 and 2 degrees of varicocele, it is necessary to take the vitamin complex and perform testicular massage.

Grade 2 varicocele need surgery? In the second stage of varicose veins, conservative treatment is possible, provided that the pathology develops normally and can be treated without surgery. Stage 2 varicocele provides the following treatment methods:

  • The operation according to the Palomo method - the procedure is performed by analogy with the Ivanisevich method, the difference is in the incision that is performed just above the inguinal region,
  • Sclerotherapy - an operation is performed by piercing with a thin needle and introducing a gluing agent through it into the dilated vein,
  • Microsurgical operation - the operation involves dressing or removing the dilated vein, the entire surgical process is controlled using a surgical microscope.

When diagnosing 3 and 4 degrees of vein expansion of the male genital organ, surgery is mandatory. The main goal of the operation is to stop the reverse flow of blood from the body directly into the diseased organ. The most effective methods are surgical ligation or embolization. If a man plans to have children in the future, it is recommended to choose embolization.

Probable complications

It is possible to exclude a complication on condition of a competent and timely selection of a treatment method. If you completely ignore postoperative recommendations, you can increase the formation of complications and relapse of the disease. Let us consider in more detail the possible complications of varicocele:

  • Testicular atrophy - organ atrophy is caused in case of improper operation, as a result, spermatogenesis is disrupted and the testicle is reduced in size,
  • Testicular hydrocele or dropsy - a complication is accompanied by excessive accumulation of fluid in the groin. Dropsy occurs when there is a violation or improper outflow of fluid, it can also occur when ligation or blocking of lymphatic vessels in the scrotum. The complication is eliminated by repeated surgery, as a result of which lymphatic outflow is restored.

For information! After the operation, a man may feel discomfort, but if there is constant and increasing pain in the groin area, it is recommended to undergo an examination.

Thanks to the use of modern methods of treatment of expansion of the veins of the male genital organs, they can reduce the level of formation of recurrence of pathology. In adolescents before puberty, the risk of recurrence is higher than in an adult male. The strict observance of all the recommendations of the attending physician and regular examination will help to eliminate the development of complications and relapse.

More information about the indications and the surgical method of treating varicocele can be found in the video.

With varicocele stage 2, it is mandatory to undergo surgical treatment. In the postoperative period, it is important to follow all the recommendations of the urologist, regularly undergo examination and take a spermogram at least 3 times in the first 6 months. As a rule, after surgery, a man improves reproductive function and spermatogenesis.

Clinic of the disease

The second stage of varicocele is intermediate. She is able to be diagnosed physically, due to the significant discomfort that a man begins to experience with the progression of pathology. If there is a 2 degree disease, patients often complain of pain that is localized in the scrotum, while the intensity of pain varies.

Many young men note sharp pains that are similar in nature to neuralgic, while others only experience discomfort while walking. Often, increased sweating and a burning sensation at the location are attached to the pain. Some patients report obvious changes in sexual function.

As a rule, almost all men, when they see a doctor, complain of regular pain in the scrotum on the left (less often on the right), as well as pain in the testicle. Pain sensations usually become more frequent during movement, with active physical exertion, taking a hot bath and sexual intercourse.

Over time, the symptoms intensify, the pain becomes much more pronounced, inflammation and swelling appear. At the same time, the scrotum sags, and the testicle becomes sufficiently dense to the touch and increases in size.

Varicocele Characteristic

Varicocele is a form of varicose veins, expansion of the spermatic cord and testicle. Due to improper operation of the valves, an increase in pressure in the veins and inversion of blood flow occur. Mostly the disease affects the left side, much less often - the right or both. The disease is activated during puberty, manifests itself and progresses in four stages.

Diagnosis of varicocele stage 2

  1. Typically, vein expansion can be detected by palpation exclusively in an upright position. The most accurate results can be obtained using the Valsalva method. During this diagnostic procedure, the patient is invited to strain slightly to increase pressure in the lower abdomen and fill the blood vessels of the testicle,
  2. To exclude the presence of formations, the phlebologist necessarily prescribes an ultrasound of the retroperitoneal space and kidneys. Pathologies that provoke the occurrence of vascular thrombosis or secondary varicocele can be detected during hardware diagnostics of CT or MRI,
  3. If the patient has reached the age of majority, he must be prescribed a spermogram (analysis of the ejaculate). With varicocele in stage 2, sperm activity is usually reduced, their number is also significantly reduced,
  4. Ultrasound scrotum and dopplerography are functional research methods. These types of diagnostics are often used to detect subclinical forms of the disease.

Stages of the disease

At the first stage, the disease manifests itself little. Attentive to his health, a man can notice a change in size, color of testicles, groping of the scrotum. This indicates the inevitability of a visit to the urologist. The specialist conducts a visual examination and palpation of the testicle. Based on the anamnesis, the doctor can send for additional ultrasound or Doppler ultrasound to determine the cause of possible changes. If necessary, medication is prescribed.

At the second stage of the disease, enlarged veins are felt in a standing position, discomfort appears in the inguinal zone, the pain is localized in the scrotum.The risk of complications becomes great, and medications are ineffective. There is a need for surgical intervention.

The third stage of varicocele is the main cause of infertility. The enlarged veins are palpated in a standing and lying position, the course of the disease is accompanied by pain during intercourse, impaired urination, a sensation of moving worms. The testicle dries up, becomes flabby. It is necessary to contact a phlebologist who prescribes research and treatment. In addition to surgical intervention, anti-inflammatory therapy is performed.

At the fourth stage of the disease, discomfort is not always obvious. However, additional diagnostics are no longer required, since problems are visible to the naked eye: nodular veins of the spermatic cord, asymmetry, muscle hardening. Recommended surgical intervention.

Drug therapy

With varicocele 2 degrees, treatment without surgery is most often prescribed with the help of medications. To combat pathology, venotonics are used, which contribute to the improvement of the state of the vascular walls.

Anticoagulants are also used, with the help of which blood circulation is normalized, the formation of blood clots is prevented. Drugs are prescribed in courses for 2-3 weeks, after which a pause is made. Most often, patients are prescribed drugs such as Venus, Detralex, Phlebodia.

If severe pain is present, then pain medications are prescribed. With the development of puffiness in the scrotum, local remedies in the form of ointments and gels help.

Attention! It is recommended to drink laxatives with varicocele if the patient suffers from chronic constipation. Indeed, regular straining is very harmful for blood vessels and can aggravate the course of the disease.

Signs of the second degree

The second degree of varicocele occurs when the expansion of the area of ​​the venous plexus reaches the stage of easy palpation in a standing position, in some cases it can be palpated and lying down. Therefore, the disease is diagnosed already at the initial examination of the patient, without additional studies.

The degree of pain symptoms may vary. One patient comes with complaints of pulling sensations in the testicles when walking, running and physical exertion, another - notes sharp pains while taking baths, sexual contact, burning sensation.

Disposing factors

Disorder of the venous valves is the main reason for the development of varicocele disease. The factors leading to violations are divided into two groups:

  • primary (or congenital),
  • secondary (or acquired).

Congenital pathology is inherited and is characterized by a weak vascular system or anomaly of venous vessels. Acquired - this is the result of increased pressure in the vena cava or renal vein under the influence of external factors, primarily lifestyle. Secondary causes of the occurrence and progression of disorders:

  • constipation
  • high blood pressure,
  • chronic inflammatory diseases of the genitourinary system,
  • adhesions in the abdominal cavity and pelvis,
  • excess weight,
  • lower back injuries
  • irregular sex
  • swelling of the kidneys
  • tumors of the kidneys and pelvic organs.

Primary factors contribute to the defeat of the mainly left testicle, and secondary factors contribute to the right or bilateral pathology.

The factor contributing to the manifestation of the disease and requiring special attention is the onset of adolescence. Up to 10-11 years, varicocele 1-2 degrees is diagnosed during a routine examination. Cases are rare (2-6%) and are due to primary factors.

Dangerous complications

The decision on the treatment remains with the patient. This is due to the history of the disease, which often reaches a certain stage and does not progress further. It should be noted that with varicocele of the 2nd degree, the consequences of untimely treatment can lead to the development of complications that are not related to the underlying disease, for example, to histological changes:

  • tissue sclerosis,
  • sagging scrotum,
  • venous wall degeneration,
  • hypertrophic changes, up to testicular atrophy.

Often, the consequences of varicocele are immune inflammation of the testis and diseases of the genitourinary system. The loss of potency is unlikely, but its reduction is possible, as a result of a drop in testosterone synthesis. Therefore, it is necessary to be treated.

Likelihood of disease progression

The progressive nature of the pathology is observed with age, the quality of the seed deteriorates by about 10% every year, and by the age of 80, 75% of men have 3-4 stages of the disease. Therefore, without treatment for varicocele of the left testis of the 2nd degree in two to three years, it can grow to the third, go to the right side. The process is caused by natural changes in the man’s body: the reverse current valves are lost over time, oxygen starvation leads to the death of testicular tissue, and immunity to their own sperm is produced.

Alternative treatment

There are a lot of recipes for home therapy

With varicocele of the 2nd degree, it is possible to treat the genitals for men with the help of folk remedies. But before that, it is important to consult with your doctor. There are a lot of recipes for home therapy, so listing everything is not possible.

The most popular are the following non-traditional remedies:

  • Apple infusion. For preparation, 3 large fruits are cut into pieces, poured with boiling water, allowed to infuse for 3 hours. Then filter and take a drink in a quarter cup twice a day.
  • Hazelnut-based infusion. Take 10 g of raw materials, pour 200 ml of boiling water, leave to infuse for 15 minutes. 800 ml of home medicine are drunk throughout the day, divided into 3 doses. Take on an empty stomach.
  • Chestnut tincture. The tool is sold in a pharmacy, but can be done at home. To do this, place the plant in a liter jar, filling only a third. Then pour vodka to the very neck and leave to insist for a month, periodically shaking. Take tincture 3 times a day for a small spoon, adding to any drinks.
  • Compress. For the procedure, make a mixture of green tea with rye bran, taking 10 g of each ingredient. The mass is filled with 50 ml of boiled milk, insisted until it cools completely, add 2 quail eggs. The prepared mixture is applied to gauze and applied to the affected area. Hold for 3 hours.

Folk remedies are highly effective, but it takes quite a long time to wait for a therapeutic effect from them. Therefore, home remedies are used exclusively as a complement to traditional methods of therapy. Do not give up medication or surgery in favor of alternative medicine.

Massage and Exercise

You need to know how to massage

To eliminate varicocele, men are recommended to massage the scrotum. It should be performed with extreme caution. Massaging should not cause pain. The procedure is carried out in a prone position with a raised pelvis.

With this procedure, blood circulation in the genital area is normalized, stagnation is prevented, blood vessels are strengthened.

In addition to massage with varicocele of the 2nd degree, doctors are advised to perform exercises. The complex of therapeutic exercises should first be discussed with the attending physician. Classes should preferably be carried out 2-3 times a day, starting in the morning.

Thanks to gymnastics, blood flow in the groin is stabilized, the tone of the vascular walls rises, and the immune system strengthens.


Varicocele 2 degrees can lead to adverse
the consequences

The implementation of preventive measures is aimed not only at preventing primary varicocele, but also to prevent the recurrence of pathology after treatment or the transition of the disease to another stage. Doctors give men the following recommendations:

  1. Do not overstrain the body.
  2. Do not lift weights.
  3. Wear tight underwear to protect your genitals from shaking. However, it should not squeeze the testicles.
  4. Regularly undergo preventive examinations by a doctor.
  5. Eat ration, enriching the diet with useful substances.
  6. Lead a regular intimate life.
  7. To refuse from bad habits.

Varicocele of the 2nd degree can lead to adverse consequences, so it is worth taking care of its treatment as soon as possible.

Varicocele 2 degrees on the left: treatment of men, do I need surgery?

Varicocele is a purely male disease of a benign nature, due to the expansion of veins in the zone of the vaginal plexus. The danger of pathology lies in the fact that untimely detection leads to partial or complete infertility.

The pathological condition is divided into four stages. If 3-4 degrees of varicocele require surgical intervention, as the only treatment option, then stages 1 and 2 remain in question.

An increase in blood circulation provokes the expansion of blood vessels, as a result of which testicular deformation is observed, a venous pattern clearly appears on it, the testicle significantly increases in size.

So, what is a varicocele of the 2nd degree, located on the left, how is the treatment carried out, and is the operation required? Find out the answers to questions in our article.

What is the diagnosis?

Medical statistics indicate that varicocele, regardless of stage, occurs in adolescents and young people. A much less common pathological condition is diagnosed in adults of the stronger sex.

In the vast majority of clinical pictures, left-sided varicocele is diagnosed - damage to the left testicle. In about 2% of cases, there is a lesion on the right side, or a bilateral ailment.

The disease itself does not pose any danger to health, does not pose a threat to life. Many men live with this diagnosis for a long time without resorting to conservative or surgical treatment.

However, varicocele in men can provoke numerous complications, ranging from premature ejaculation and problems during urination, to male infertility.

In the early stages of the disease is difficult to identify. The fact is that veins do not change the appearance, local blood circulation worsens, but this does not affect the general well-being of the patient.

In more rare cases, in the early stages, a man feels discomfort during sexual contact, but almost no one seeks help from a medical specialist, preferring to cope with the difficulty on his own.

With varicocele of the 2nd degree, anxiety sets in. Since the swelling of the affected veins is detected in the second stage, they braid the testicle with a barely noticeable bluish net. As noted, the left testicle is almost always affected, but there is also a right-sided disease.

With the progression of the pathology, the symptoms intensify, pain is detected, swelling and inflammation in the affected area are not excluded. The scrotum sags, the testicle greatly increases in size, becomes denser.

For the second degree of varicocele, numerous complications are characteristic.

Therapy options

Varicose veins of the dilated veins are diagnosed by palpation when the patient is in a standing position and strains. In this case, an obvious lesion of the testicle is revealed, and palpation allows you to detect its transformation in consistency, if any.

If there are doubts about the diagnosis, the doctor recommends an ultrasound examination of the testicles. In some situations, a diagnostic method such as dopplerography is prescribed. This method makes it possible to determine the state of the veins, the nature of blood circulation, the presence / absence of reverse blood reflux.

If there is a suspicion of impaired testicular function, a medical specialist will prescribe a spermogram.

Against the background of the second stage of the disease, treatment is performed without surgery, that is, through conservative therapy, including:

  • Venotonic medicines (venotonic), aimed at improving the condition of veins and blood vessels.
  • Anticoagulants that help improve blood circulation, prevent blood clots. Usually, the duration of treatment with them takes about 20 days, after a break. If necessary, the course of administration is repeated.
  • If symptoms such as pain, swelling, severe itching and burning are observed, then the doctor prescribes local remedies, which include anesthetic substances.

The treatment regimen may include various drugs, depending on what symptoms are observed in men. Severe pain relieves analgesics, mild laxative drugs that do not have an irritating effect on the intestinal wall fight chronic constipation.

As an express agent, glycerol-based suppositories that do not contribute to the disruption of the normal intestinal microflora can be used. This method is good for self-treatment.

How to stop the progression of pathology?

To prevent the progression of the disease, respectively, its transformation from the second to the third degree, it is necessary to exclude negative factors. A man’s menu plays a special role, so it’s important to refuse food that adversely affects the state of blood vessels.

Smoked dishes, marinades, canned goods can provoke further expansion of veins. It is recommended to abandon table salt, giving preference to products abundant in natural sodium - green vegetables, tomatoes and root crops.

An equally important point is the prevention of constipation. Strong straining in the process of bowel movement provokes a large flow of blood into pathological veins, as a result of which the picture and symptoms of pathology are aggravated.

Any disease based on the expansion of the venous plexus requires the abandonment of bad habits. Therefore, patients should absolutely abandon the use of alcoholic beverages, smoking.

Nicotine, which enters the body of a man during smoking, contributes to the violation of the walls of blood vessels, makes them brittle and brittle, provokes their transformation, and affects the full circulation of blood.

Optimum physical activity, which eliminates exorbitant loads on the body, helps to strengthen the tone of the veins. For example, gymnastics, slow running, swimming. Power sports are excluded, as they adversely affect the state of blood vessels. You can go in for sports with varicocele daily.

Varicocele stage 2 is the best time for a surgical procedure. Timely surgical treatment significantly improves the patient's condition, solves aesthetic problems, eliminates the risk of infertility.


Genetic predisposition is the leading factor in the occurrence of varicocele. It can occur if one of the parents of the man or close relatives suffers:

  • Heart failure
  • VRV of the upper or lower extremities,
  • Pathologies that are related to connective tissue
  • Hemorrhoids
  • Flat feet.

If there are similar genes, a man’s tendency to varicose disease of the seminiferous tubules can manifest itself with various deviations in the functioning of the venous system:

  1. Pathologies and impaired blood flow in the valves, which prevent the reverse movement of venous blood, while creating additional pressure,
  2. Sometimes venous valves are completely absent.A similar pathology develops in the fetus even in the process of its formation during pregnancy,
  3. There is also a congenital predisposition in which the walls of the blood vessels are weakened, which contributes to their stretching.

Anatomical features

The pathology, which occurs mostly on the left side, is due to the anatomical feature (as a rule, in healthy men, usually the left testicle is slightly lower than the right). The occurrence of varicocele sometimes depends on the close contact of large blood vessels and veins combined with them.

Therefore, with regular jamming of a vein that leaves the left kidney, a primary (idiopathic) disease develops.

This feature may also cause a hereditary factor. The most characteristic of idiopathic varicocele is the rapid filling of the blood-shaped plexus vessels with blood while the patient is standing. In the supine position, the pathology is practically not felt.


Regular cardio loads can also trigger the occurrence of varicocele 2 degrees. Strength exercises involving the use of barbells, weights, dumbbells, as well as prolonged running and press loads have a very negative effect. Such manipulations with the body contribute to increased pressure in the veins and entail the development of the disease.

The development of varicocele most actively begins to manifest itself in adolescence, when young people have a desire for sports characteristic of this age. As a rule, most often the choice falls on power sports, which, in the presence of a predisposition to the disease, are categorically contraindicated.

If there is a lot of zeal for training, in order to prevent, it is better to abandon the exercises, where the emphasis is on the legs.

Excess weight

For the manifestation of varicocele, overweight is also a risk factor, which is caused by certain mechanisms of the body: adipose tissue is able to exert pressure on the blood vessels, which provokes their narrowing and, as a rule, leads to the formation of varicose veins.

Overweight patients almost always have heart problems. The development of atherosclerosis and blockage of blood vessels contributes to increased cholesterol. A varicocele, with the whole set of cardiovascular diseases, develops gradually, as a concomitant pathology.

In this case, the prevention of varicocele can be a reduction in excess weight. To do this, reduce the consumption of abnormal amounts of simple carbohydrates and fats, engage in light physical activity, and lead an active and healthy lifestyle.

Ability to conceive

40% of men undergoing treatment for infertility, find themselves varicocele on the left 2-3 degrees, which they did not suspect before. With this pathology, the barrier venous wall wears out, and the body's immune system begins to inhibit a healthy testicle, taking it for a foreign body. The number of spermatozoa decreases with their motility due to an increase in the temperature of the epithelium.

Diagnosis confirmation methods

The purpose of diagnosis is to determine the form and degree of the disease to select effective treatment methods.

During the examination, the urologist, in addition to palpation, uses the Valsalva method, when the patient holds his breath for 15 seconds, strains his stomach and fills the blood vessels of the testicle.

If the diagnosis is not obvious or clarification is required, the patient can be referred for a number of additional studies:

  • ultrasound examination of the scrotum, pelvis, abdomen and kidneys,
  • computed tomography (CT),
  • magnetic resonance imaging (MRI),
  • contrast studies
  • spermogram.

Ultrasound and duplex studies allow you to evaluate the change in testicular volume and see the return flow of blood. Hardware diagnostics (CT and MRI) identify the causes of thrombosis and possible relapses. Contrast shows the anatomy of the left renal vein system. All men who have reached the age of majority are given a spermogram.

Treatment methods

Most experts agree that with a diagnosis of varicocele of the 2nd degree, treatment without surgery is impossible. Conservative therapy is a less effective way to combat the disease, cannot guarantee a complete recovery, so it should be considered as a supporting measure.

Operation: do or not

With varicocele of the 2nd degree about whether an operation is needed, there is no consensus. Surgical intervention is advisable for pain and infertility at a young age. If a man does not plan to have children, nothing bothers him, you can undergo medication.

The method of operation is selected based on the manifestations of the disease and its cost. There are two types of intervention:

  • surgical ligation, intersection or removal of a vein,
  • vein removal, followed by restoration.

The first type of surgical intervention involves a complete stop of blood flow in a vein. This procedure is called varicocelectomy, it is carried out in different ways: Ivanissevich, Marmara, Paloma, Kondakovo, endoscopy, sclerosis. Advantages of the operation: ease of execution, small damage to the skin, quick rehabilitation and the relative cheapness of the procedure. Possible complications: relapses and the likelihood of breaking the barriers of the immune system.

The second type of intervention is plastic surgery, which is called microsurgical revascularization of the testicle, which implies a complete resumption of blood circulation. The procedure is difficult to perform, so the price is high. The cost justifies the fact that relapses are excluded in this case.

Conservative therapy

Drug therapy is carried out only on prescription. Given the symptoms of the disease, prescribe: venotonic drugs, anticoagulants (prevent thrombosis), local remedies - analgesics, laxatives and anesthetics. The necessary stabilizing effect of blood flow is given by physical therapy exercises and massage.

Military conscription and varicocele 2 degrees

Varicocele of the 2nd degree is a limitation for military service (category B), studies at a military school and higher institution with a department for the training of reserve officers. Depending on the severity of the disease, a man can be sent to the infantry unit, railway troops, construction battalion, or they will be given a delay of up to one year for the operation. If relapse occurs during the service, then surgery is performed in the nearest hospital, followed by return to drill.

Stage 3 Prevention

Stress, the lack of drug support, infectious and venereal diseases, alcohol, sauna and physical exertion can provoke the transition to the third stage of varicocele.

It is necessary to independently examine the scrotum once every six months, and not only on the left, since the manifestations are not always noticeable from this side. A positive restraining effect is exerted by morning workouts, hiking, and the use of vegetables and fruits.

It is necessary to treat varicocele. Ignoring the underlying factors and untimely seeking medical help can lead to irreversible degenerative processes in the testicles. An annual examination from an early age and the right lifestyle will be the key to men's health.

How to treat varicocele 2 degrees?

Diseases of the organs of the male reproductive system in most cases have pronounced negative consequences, so they should be diagnosed and treated in time. One of the common pathologies among men of reproductive age is considered varicocele 2 degrees.

Most often, the disease occurs in adolescents after the onset of active puberty. The main mechanism for the development of varicocele is varicose veins of the spermatic cord and a violation of the normal outflow of venous blood from the testicle.

In most cases, the pathological process is localized on one side (usually on the left), in some men the disease may be asymptomatic. It is important to contact a qualified urologist or andrologist in time if symptoms of varicocele appear.

Ignoring varicocele or self-medication can have serious consequences for your reproductive health.

The main reasons are:

  • Features of the inflow of the left vein of the spermatic cord into the renal vein (in a position at right angles).
  • Venous valve dysfunction, which play a key role in maintaining normal vein pressure (increased hydrostatic pressure expands the lumen of the vessel).
  • The development of neoplasms in nearby tissues that can compress blood vessels.
  • The presence of a hereditary predisposition to varicose veins.
  • Blood stasis in the pelvic organs.
  • Inflammatory and infectious diseases of the reproductive organs.
  • Regular physical stress associated with lifting weights.

In the process of diagnosing a disease, it is very important to accurately identify its cause, since the tactics of subsequent treatment depend on it.

How to determine the degree of varicocele

Depending on the severity of the pathological process, three degrees of the disease in men are distinguished. Doctors use a Valsalva test to diagnose varicocele, the man is asked to close his nose and mouth tightly and try to exhale forcefully.

During the test, the man's muscles of the abdominal muscles are significantly tensed and this allows us to assess the condition of the spermatic veins.

Varicocele of the first degree can be detected only after a Valsalva test or with the help of dopplerography of blood vessels.

A man must make a spermogram to assess the function of his germ cells. Grade 2 disease is characterized by a decrease in sperm motility.

With varicocele of grade 3, pathologically altered vessels can be noticed during the examination of the scrotum, by ultrasound significant vein expansion is determined the plexus plexus. The concentration of sperm in the ejaculate and their mobility is reduced. Depending on the degree of the disease, the doctor will offer the man the most effective treatment methods, so it is important to undergo all the necessary diagnostic procedures.

No operation

For the treatment of varicocele of the 2nd degree, you can also use a conservative tactic, but the operation completely solves the problem of expansion of the veins of the spermatic cord.

In some cases, men are recommended to perform special physical exercises, for example, to stand on their toes and perform inclinations several times a day. To improve the outflow of blood, you can also lie with a raised pelvis during rest.

With operation

In modern urology, they resort to minimally invasive operations to remove the dilated veins of the plexus plexus.

Usually, after surgery, the patient quickly recovers, but for a certain time it is necessary to refrain from physical activity and sexual activity.

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Neoplasm development

In the process of the development of any formations, near the organs of the lower abdomen or pelvis, pinching of the veins can occur, which feed the scrotum and testicles. These processes often contribute to the appearance of varicose veins in this area and provoke the development of varicocele.

At the slightest suspicion and the presence of even minor pain or discomfort, immediate expert advice is necessary.

Vascular clearance

This pathology in men is a common cause of high blood pressure, which contributes to the stretching of the vascular walls. This hereditary factor is of a secondary nature. However, if there are anatomical pathologies of the male gonads, in which the veins of the testis and spermatic cord are squeezed, this is the main provoking factor. The lumen of the vessels can narrow for a number of reasons:

  • When a vein is located between the vessels that squeeze it,
  • If the vein that feeds the testicle bends,
  • With the formation of scars on tissues adjacent to the vein, the causes of which are due to surgical intervention, inflammatory processes, infections or injuries.

To reliably determine the source of development of varicocele in adolescence, a number of studies are prescribed, instrumental and laboratory.

Occupational Risks

Work associated with weight lifting and a long stay in a standing position, contributes to the formation of not only varicose veins of the lower extremities, but also the occurrence of varicocele. This happens due to constant pressure in the veins. A very negative effect is exerted by the pressure of the muscles of the press.

If after lifting weights or a long stay in a standing position, pain is observed in the scrotum, a man should visit a urologist.

Irregular sex life

If a man does not have a permanent sexual partner, prolonged abstinence is replaced by frequent sexual activity. This negatively affects the reproductive system of the male body. Since it is customary to consider the presence of two or three contacts within a week.

If a man leads an irregular sex life, this provokes stagnant processes in the blood vessels. However, the other extreme is also undesirable. Too frequent sexual acts contribute to additional pressure in the veins of the testes and scrotum.

Watch the video: Varicocele Repair (February 2020).

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