"Life gets real when 'don't want' becomes 'can't have'."
American comedian Hasan Minhaj in his latest Netflix special - The King's Jester hits us in so many ways.
Minhaj openly speaks about how he was the reason his wife and him were struggling to have a child. He explains the varicocele diagnosis – something that is rarely spoken about.
So what is varicocele? Can it be fixed? FIT spoke to experts to understand this better.
What is Varicocele Repair?
"A varicocele is diagnosed when small veins bringing blood from the testis become enlarged inside your scrotum (the pouch that holds testicles). These veins are known as the pampiniform plexus," says Dr Ritesh Goel, Consultant, Department of Urology, Amrita Hospital, Faridabad.
He also mentions that varicoceles are more common on the left side of the scrotum. Varicocele repair involves ligating these veins using microsurgical techniques.
The increased blood flow in that region leads to a high local temperature. This high temperature impairs sperm count and motility leading to infertility.
When Does a Person Need Surgery?
According to Dr Surveen Ghumman Sindhu, a person needs this surgery when the sperm count motility and morphology are affected.
The presenting symptom would be the inability to have a child, decreased testosterone hormone production, and pain and heaviness in the scrotum. Physical examination and scrotal ultrasound would diagnose itDr. Surveen Ghumman Sindhu - Senior Director & HOD - Infertility & IVF, Max Multi Speciality Hospital, Panchsheel Park
Most of the patients with varicocele do not have any complaints. Complaints may include discomfort and heaviness in scrotum to unbearable pain. These symptoms worsen after prolonged standing.
"Another concern is that varicocele may be the cause of fertility problems due to reduced sperm count and quality," says Dr Ritesh Goel.
What Happens in This Surgery?
Dr Ritesh says, "During a varicocele repair surgery, the veins are microsurgically ligated, and care is taken to preserve other structures. This technique of microsurgical varicocelectomy (MVL) has the least risk of complications."
Rarely some patients may develop fluid within their testis known as hydrocoele and some may experience some temporary numbness.
How Does It Impact Your Recovery?
"The patient can go back home the same day itself. It may take a few days for complete recovery but the patient is mobile. It takes 2 weeks for complete recovery." says Dr Dr Surveen Ghumman Sindhu.
Do You Feel the Stigma Regarding Male Fertility is Extreme?
Male infertility remains a stigma in many cultures and is mistaken with a lack of masculinity. "For men, this may result in keeping secrets during assessment leading to missed diagnosis. This sometimes worsens to the point where the female partner takes the blame for the couple's inability to conceive," says Dr Ritesh Goel.
Because of the stigma attached most men get tested only after the woman has done it which leads to waste of time and resources.
How Can One Help Destigmatise This ?
Men must realize that varicocele has nothing to do with masculinity. Also, male evaluation is done confidentially, and surgical correction of varicocele does not hamper any sexual activity. Surgical repair of varicocele will improve quantity and quality of sperms.Dr. Ritesh Goel, Consultant, Department of Urology, Amrita Hospital, Faridabad
There are many couples that are now coming forward for assessments at an early age. It is recommend that males should come forward and get evaluated as most of the reasons of male infertility are correctable.