Varicocele And Kindred Disorders

This is a fairly common male disorder, consisting of a swelling or enlargement of the veins of the spermatic cord present in the scrotum. The enlargement of the vessels may be slight and insignificant or so prominent that the scrotum also becomes quite swollen and pendulous. Usually it exists in mild degree, and is said to occur in about one in every ten young men. Many of those with mild varicocele give the condition more thought and worry more about it than some with a pronounced degree. The condition results from disturbances of the local circulation.

In some cases there is fullness and twisting of the spermatic veins in which there is no definite varicocele, the veins being normal and the functions normal. Varicocele is one condition which charlatans and quacks in the past have utilized to increase their revenue – at the expense of the peace of mind of their patients. They often make much of insignificant degrees of varicocele. Unscrupulous physicians often claim that every other possible sexual ailment except venereal disease results from or can result from varicocele.

The spermatic cord is a sheath-like structure suspending the testicle on each side, and containing the duct of this gland, the vas deferens, the spermatic arteries and the spermatic veins, which take the form of a network. A poor general circulation and any condition which results in local congestion in the parts, general low tissue tone, constipation, lifting of heavy weights, long standing on the feet, bicycle riding and certain jars and stresses may cause varicocele.

Symptoms: Upon palpation of the scrotum there is felt within it a mass resembling earthworms. These may be few or many. There may be no other signs (other than the enlargement of the scrotum) or symptoms. The scrotum also usually hangs very low, particularly on the left side, and in pronounced cases or in nervous individuals there is a sensation of weight and a dull dragging sensation. Sometimes an aching pain is quite pronounced. There may be tenderness in the veins of the parts involved, or of the spermatic cord or of the testicle.

There are several reasons why varicocele is more commonly found on the left side. First, the left cord is longer than the right; second, the left spermatic vein opens at right angles into the left renal vein, which does not favor ready return of blood on that side, while the right spermatic vein empties at a pronounced angle; third, the left spermatic vein runs behind the sigmoid colon, with the result that in constipation there is pressure upon and obstruction of the vein, which produces the stagnant circulation in the scrotum. Therefore the person who is habitually constipated is much more likely to develop varicocele than the one whose bowels are functioning normally.

Long standing does not have the effect of producing varicocele, unless there is defective circulation or general weakness and lowered tone of the tissues. One who is physically active and energetic may remain on his feet for long hours daily without the development of varicocele, provided other factors also do not tend to produce it. General debility and lack of nerve- and muscle-tone is one of the prominent causes and is necessary, in fact, to the development of a pronounced degree of the condition. Another important factor is continued or frequently repeated congestion of the parts due to too much sexual excitement, especially in early life. Masturbation, through its effect in causing frequent engorgement of the veins and a state of more or less general debility, may be a factor in the development of the condition. Many believe that all cases of varicocele result from masturbation or some sexual excitement, but this is far from a fact.

Sometimes a truss worn for the relief of a hernia may cause varicocele. Sometimes the hernia itself will result in the condition through direct interference with the return circulation. Any other type of tumor located in this region may have a similar effect. Lifting of heavy weights, especially when certain of the abdominal structures are not on guards may produce it; also sedentary habits.

In a great many cases worry has done more to reduce the general health than has the varicocele itself. There is no occasion to worry over the condition, and nothing need be done in the very mild cases. Some cases become so pronounced, however, that there is failure of development of the involved testicle; or if there is development It may gradually atrophy because of the failure in its circulation. In this case there is more or less “sickening” ache in the testicle itself during the process of atrophying. In these cases the testicle function becomes much impaired, but the other testicle may maintain normal sexual vigor and productivity.

Treatment: Since it is poor general tone, vigor and circulation that make the condition possible, whatever factor or factors may have been responsible for its immediate development it is necessary that the treatment include those factors which have to do with building up the body and the quality and circulation of the blood to the highest degree possible. One of the most important of all factors of treatment is cold applications. The cold sitz-bath is the best single factor in the treatment of this trouble. Sometimes through the draining of the vessels by the cold bath and the improved local tone, there will be an eradication of the trouble if causes have been removed. In any case, however, the cold will have the effect of removing the feeling of tension and bearing down so common to this affliction.

The hot sitz-bath should not be taken in this condition unless there is pain or unless there is inability to react from a cold sitz-bath. In this latter case, the hot sitz-bath may continue for a minute or two in order to improve reactive powers. The cold sitz-bath may and should be taken morning and evening. The colder the water the more valuable will the treatment be, but reaction is necessary, of course. At any time the hot sitz-bath is taken, it should always be followed by the cold sitz.

Another excellent bath is taken as follows: Seated in three or four inches of cold water in an ordinary bath tub, after two or three minutes use the cupped hands in the order of a water wheel between the flexed knees to splash the water quite vigorously against the scrotal area. A modification of this treatment is to have the arms on the outside of the legs (knees flexed), which gives a more pronounced splashing effect against the perineal region. Still another very excellent cold water treatment is the cold spray with a portable hand spray.

While seated in the bath tub, or while supported over the side of the tub (so that the hips are suspended inside and the back leaned against one side of the tub while the knees support the body on the other side), one may play the cold spray as long as desired with less chilling effect upon the body as a whole, thus resulting in more prompt reaction. After this spray has been given to the scrotal, perineal, and lower abdominal regions, it may be given also to the lumbar region of the spine. This is the sex center of the spine, and treatment at this region will have a good tonic effect upon the circulation throughout the sexual system and pelvis. The alternating hot and cold sprays may be given to this region with benefit, terminating with the cold.

Exercise is very necessary for the correction of this trouble. While standing may aggravate the condition, walking and running will tend to drain out the veins of the scrotum through the effect upon the entire general circulation. Running while in one place, rope-skipping, moderately fast walking and running, or any one or more of these should be included in every system of treatment for this trouble if there is no contra-indication. Other exercises of value are those taken reclining, either on the level or, especially, on the slanting table – such as were recommended for rupture. One may lie on the inclined table several times daily without exercise, but at least once a day exercise should be taken, mainly on the back^ but also some movements face down – all taken head down.

Diet is of considerable value in this condition also. It is important that a diet providing ample bulk and laxative foods be provided so that bowel functioning is maintained at normal or is re-established. The milk diet is one of the best diets for the condition. It gives the blood all the elements that are required, but it gives ample fluid also, and the circulation in general is pronouncedly increased on this diet. This is what is required for the correction of varicocele. Naturally if the milk diet is constipating, the enema must be used, or bran, bran muffins, figs or prunes in sufficient amounts to secure at least two good evacuations daily. If the milk diet is not used there should be considerable milk in a diet otherwise composed of natural foods.

The wearing of a supporter with elastic straps is advisable when there is pronounced distension of the veins, or when there is tenderness and pain or a dragging sensation. Within a comparatively short time these sensations will be reduced, but it does no harm to wear the support. After the cold water treatment by any of the methods suggested above, the sac of the supporter may be wrung from cold water before putting it on. This, with the outer clothing, has somewhat the effect of a heating compress.

One remaining leading factor of treatment, and in some cases the most important of all, is the avoidance of sexual excitement and erotic thoughts. So long as physically or mentally one is maintaining a congestion of these parts, it is impossible for any combination of treatments that do not include surgery to correct the trouble.

Keeping the mind on other subjects and free from worry over the existing condition, adopting a blood-making diet of vital foods only, with ample fluid, exercising sufficiently to develop good muscle tissue and muscle-tone, securing enough relaxation that there is no enervation, and also employing local treatment, will do wonders in this condition and often in time will completely restore the parts to normal. Whether or not they have this perfect effect, they will prevent aggravation of the condition, will remove unpleasant sensations resulting from it, and will maintain functioning of the sexual glands.