There are quite a few treatment options available for the treatment of varicocele that will improve fertility. Learn about the best diet plan for you to avail.
It can be scary when you are unaware of what exactly is going around with you and things just don’t seem right. You may be feeling pain or facing infertility issues with your spouse. Seeking help from a healthcare professional as soon as possible is best. Fortunately, there are some non-invasive alternatives to surgical procedures such as diet-based treatments that you could follow while practicing a healthy lifestyle to get you right back on track.
Varicocele: Simplifying the understanding
If you’re already familiar with varicose veins, varicocele is only different in terms of specificity of location. While varicose vein is a condition wherein superficial veins, at any location throughout the body (but usually in the legs), may get enlarged, if these enlarged veins exist around the scrotum, they are known as varicocele. To delineate, varicocele is a clinical condition as a result of abnormal and torturous dilatation of scrotal veins in the pampiniform plexus of the spermatic cord. It can be graded according to the clinical findings on palpitations, ranging from grade 0 – 3 through different diagnostic techniques such as physical examination, scrotal ultrasound, venography, and color doppler ultrasonography. Where grade 3 varicocele is easily identified through physical examination, but lower grade varicocele could be difficult to identify, particularly in certain clinical comorbidities. As scary as it sounds, it can be treated by seeking medical help from your primary health physician at the earliest, which is when you experience any type of discomfort or pain in your groin region. Men who suffer from this condition experience symptoms such as mild to intense pain leading to infertility, and shrinking testicles.
Side-Effects of Varicocele
Deemed as the most common yet correctable cause of male infertility till date, a number of scientific investigations over the century have associated varicocele with pernicious effects on spermatogenesis, semen quality, testicular volume, reproductive hormones, and failure or difficulty in achieving pregnancy. Along with these negative consequences, it may also cause great mental distress to the affected person.
How Varicocele Causes Infertility
Spermatogenesis itself is a temperature sensitive process. In such patients, regurgitation of warm abdominal blood through incompetent valves elevates the scrotal temperature. Considering sperm functions such as motility and capacitation are all energy dependent processes, therefore, spermatozoa have very high-energy requirements. Factors that affect spermatogenesis and semen quality act by decreasing the availability of energy by mitochondrial dysfunction. Spermatozoa are especially vulnerable to reactive oxygen species (ROS) whose elevated levels result in heat and oxidation resulting in membrane instability and damage along with functional alterations such as increased DNA fragmentation that ultimately result in cellular death.
Treatment Options for Varicocele
Listed below are some of the available treatment options for patients suffering from varicocele:
Surgical Procedures for Varicocele
At present, there are three types of surgical approaches in practice, to alleviate this condition namely, laparoscopic surgery, open surgery, and microsurgery. All of these options involve hospitalization, incisions, extended recovery time, scarring and potential for recurrence.
However, there are also natural and diet-based alternative treatments in the market that varicocele patients can take advantage of.
Healthy Diet
Foods that are high in fiber and antioxidants are exceptionally good for treating varicocele. Diet that is high in antioxidants protects the veins in the testicles from the damaging effects of ROS. Also, fiber is another food component that can help alleviate these conditions since it relieves constipation that may also cause varicocele.
In order to get the best treatment out of these, try to eat antioxidant and fiber-rich food in abundance on a daily basis. Some foods that are rich in these nutrients include collard greens, beans, oats, pecans, cauliflower, and chocolate. You should start noticing improvement in fertility and decreased testicular pain with their regular use.
Supplements
Supplements might be good for you since our daily diet lacks all the necessary nutrients, therefore, taking supplements allow us to consume the nutrients that we are missing out on. Such as consuming vitamins, bioflavonoids, and zinc tablets.
However, before taking any supplements, it is wise to take your doctor on board since these can aggravate a pre-existing condition, as well.
Comfortable Clothing
Patients suffering from varicocele should try boxer briefs also known as varicocele underwear. These provide more scrotal support than the regular underwear, which is important in allowing normal blood flow to the testicles. Also, make sure you are wearing the right fit to allow right blood flow and reduce heat generation that can be caused by wearing smaller sized boxers. You may experience reduced pain after its regular use.
Exercise and Meditation
Going to the gym and swimming a few laps would do you good if you’re experiencing varicocele. Especially swimming, since it keeps your body cool and allows proper blood circulation, etc. You can also use an ice pack, but don’t ever put it on your bare skin for more than 10 minutes at a time. Also, avoid smoking, since tobacco contains chemicals that might alleviate your varicocele through accumulation.
As science and technology are advancing, one can avail better and non-invasive options. So far, the best treatment for varicocele available is the non-surgical, minimally invasive, endovascular treatment. Varicocele treatment in Pakistan was introduced by Dr Imtiaz Ahmed, who is an endovascular Surgical Specialist, and an Interventional Radiologist Men who are young and respond, certainly not very well, but to some extent to PDE5 inhibitors are strongly advised to undergo varicocele non-surgical treatment. The non-surgical endovascular treatment takes on two main approaches: antegrade and retrograde. Both approaches aim to embolize the periprostatic venous plexus along with other veins that may seem irregular in shape or function. Antegrade endovascular treatment is performed via the deep dorsal penile vein, while retrograde treatment involves a transfemoral path via the internal iliac vein. Fluoroscopic guidance helps the catheter reach the selective veins, after which glue therapy is performed using specialized FDA approved drugs. Out of the two approaches, specialists prefer using the antegrade approach, which provides a much straighter route to the periprostatic veins. The non-surgical treatment for varicocele is a complex and challenging procedure which requires expertise in the field.
Complete lifestyle changes even after a definitive cure, like the endovascular treatment by Dr Imtiaz, is cardinal to achieve maximum benefits out of the treatment itself. A diet rich in antioxidants and balanced in other major macromolecules cements long-term results, helps expedite recovery, and all in all, improves the well-being of the patient.
Fibroids are considered amongst the most prevalent clinical conditions in females of reproductive age. Learn more about successful pregnancy with fibroids.
Women are key players in maintaining a healthy family environment, however, this also comes at a price since many women either ignore or suffer in silence when it comes to their own well-being. Many women reading this have a great chance of developing uterine fibroids in the future, or may already be affected by it. But need not worry, there are a number of successful pregnancy stories of women with fibroids and fibroids pregnancy is becoming more common now.
What are Uterine Fibroids?
Uterine leiomyomas, routinely known as “fibroids” are the most common benign tumors or non-cancerous growths of uterine smooth muscle cells in women. Uterine fibroids are the most reproductive ailments in women with an incidence of up to 40-60% by age 35 and 70-80% by the age of 50 such that up to 75% of the women worldwide will be affected by it at some point in their lives. As women age, the likelihood of developing fibroids increases. Some women with fibroids are asymptomatic, while others experience intense pelvic pain, bloating and heavy menstrual bleeding that can affect their day-to-day life. Although its etiology largely remains unknown, it has been linked with many factors such as age, family history or genetics, obesity, and poor lifestyle comprising eating habits and exercise. Scientific investigations have revealed that ovarian steroids, namely, estrogen and progesterone along with many cell-growth factors are also involved in the growth of fibroids.
Types of Fibroids
The size of the fibroids ranges from a seedling to an enlarged, bulky mass. Depending on the location of the growth, fibroids are classified as following:
Intramural fibroids – the most common type that appear in the muscular uterine wall.
Subserosal fibroids – appear on the outer lining of uterus, known as serosa.
Pedunculated fibroids – subserosal tumors that develop a stem to support the tumor.
Submucosal fibroids – they develop in the myometrium, the middle layer of uterus.
How are Fibroids Diagnosed?
Being diagnosed with fibroids is no reason to despair, contrary to the usual norm. Fibroids remain a largely misunderstood and underfunded gynecological condition worldwide. In order to clarify all your misunderstandings, take the matter in your hands and seek medical advice.
Fibroids can be diagnosed by simple physical examination by your gynecologist. Moreover, ultrasound and pelvic MRI are also performed for smaller and complex fibroids.
Effects of Fibroids on Fertility
Although they are extremely common, uterine fibroids may Uterine fibroids effect your fertility and your ability to carry a pregnancy successfully. However, its effects on fertility are highly variable, since many women experience either no fertility issues or complications during pregnancy due to these masses.
How Does Uterine Fibroids Affect Pregnancy?
The diagnosis of fibroids during pregnancy is not a simple task. Around 42% of large fibroids that are approximately 5 cm and 12.5% of smaller fibroids that range between 3-5 cm can be diagnosed through physical examination. Use of ultrasound to detect these tumors in pregnancy is much more restricted, primarily due to the difficulty in differentiating fibroids from the thickening of the myometrium during gestation. Therefore, its prevalence during pregnancy is highly underestimated. As it has been observed that there has been a growing trend towards late conceptions, therefore, its incidence in older women with infertility issues is reportedly higher to about 12-25%. Nevertheless, there are contradictory findings on the effects of fibroids during pregnancy outcomes, since most women with fibroids experience no issues with fertility that conclude in natural and uneventful pregnancies. Although the majority of fibroids don’t change their size, but in other cases they may grow in the first trimester due to increased estrogen levels in the body during pregnancy. However, around 10-30% fibroids have been associated with an increased rate of complications during pregnancy.
Complications in Fibroid Pregnancies
If you get pregnant while being diagnosed with fibroids, there’s a high chance of obstetric complications that may include:
Pelvic Pain
Bleeding
Spontaneous miscarriage
Breech Position
Placenta abruption
Preterm labor
Cesarean delivery
Postpartum hemorrhage
Amongst all the complications, pain is the most commonly experienced in women with large fibroids up to 5 cm. Especially during the second and third trimesters of gestation. The size and location of the fibroid along with the physical obstruction may explain some of these outcomes and the type of delivery.
Fibroid Treatment Options
There are a number of procedures and treatment options available for fibroid patients and women can opt for their choice of treatment plan by discussing with their obstetrician. Some of these include:
Medications
Medications that regulate hormonal levels are prescribed to fibroid patients. Gonadotropin-releasing hormone (GnRH) agonists such as estradiol and leuprolide are used commonly to stop menstruation and shrink fibroids. While others can control bleeding and pain however, they only offer temporary relief.
Surgical Intervention
Surgical procedures such as myomectomy (removal of fibroids without compromising healthy uterine tissues) and hysterectomy (removal of uterus) are painful and invasive procedures that women can also opt. However, these are followed by total inability to conceive along with increased chances of fibroid recurrence.
Noninvasive Treatments
There are a number of new and minimally invasive treatment options in the market that include Focused Ultrasound Surgery (FUS), that uses high-energy ultrasound waves to locate, heat up and destroy the bulbous mass. Endometrial Endometrial ablation is yet another option in which the lining of the uterus is removed using electric current or laser amongst other options. Similarly, Myolysis uses a needle that is inserted into the fibroids guided by laparoscopy and either electric current or freezing is used to destroy the fibroids.
Uterine Fibroid Embolization (UFE) is a popular non-invasive, patient compliant, and safe approach towards removing uterine fibroids that is performed by interventional radiologists using live imaging techniques. This is a highly accurate, multistep procedure that uses a thin tube which is threaded into uterine arteries that supply blood to the fibroid. Then, small molecules are injected into the blood stream which block blood supply to the fibroid, causing it to shrink with a success rate of 95-97%. The procedure provides immediate relief without comprising fertility and chances of conception.
UFE treatment is now available in Pakistan for the first time since 2017, in two of its major cities; Karachi and Lahore. The embolization procedure is carried out using an FDA approved drug by Dr. Imtiaz Ahmad, who is a renowned interventional radiologist and endovascular surgical specialist. As a part of post-treatment practice, the patient can expect a follow-up up to 6 months. There are numerous success stories of patients that underwent UFE procedures performed by Dr Imtiaz Ahmed that speak for his expertise in this area.
