The Varicocele - Topic

Excellator

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Defective Valves Are Not The Cause Of Varicocele, Urologists Are Wrong

For a long while I've been trying to figure out what the exact background of varicocele is since I suffer it myself. I always thought that surgery was invasive and that cutting the spermatic vein is a one-way road. This is how the surgical procedure is done, after which the two sides of the vein are tied off. The reports on the material used in some coils for the alternative of surgery, varicocele embolization, causing cancer aren't making me excited either.


The consensus on what the cause of varicocele is according to urologists universally is defective valves, notably defective valves right above the pampiniform plexus.


Now I have come across a study that confirms what I have been thinking all along, that this theory is wrong. In fact, this recent study proves that veins are not a causative factor at all, as it shows healthy veins with absence of any valves.


https://www.researchgate.net/publication/287626428_Valves_of_the_gonadal_veins


Purpose: Varicocele seems not to rely on the number of valves within the pampiniform plexus, the initial failure might be located on a higher level. Therefore, the failure should also occur in females. There is a comparable disease, Pelvic congestion syndrome, as result of pelvic venous engorgement due to gross dilatation and incompetence of ovarian veins. Thus, we need a detailed description of venous course, branching as well as frequencies and locations of valves within both genders. Page 3/23

Material and Methods: In 31 Caucasian formalin-fixed bodies (15 males, 16 females) we investigated course and valves from Ovaries or internal inguinal ring, respectively, up to termination into inferior vena cava or left renal vein, respectively. Specimens were documented photographically and by a distinct protocol.

Results: In general, we found one valve on each side (testicular vein right 41.93%, left 51.52%; ovarian vein right 51.61%, left 45.45%). Two specimens had two valves per vein, each in a left testicular vein, and 15 veins showed absent valves. Valves existed between 0.0-4.5 cm, mainly 0.0-1.0 cm. One corpse showed varicose ovarian veins.

Conclusion: If veins show varices, one would expect missing valves or insufficient function. In contrast, none of our 15 valve-less veins showed varices or even enlargement. Also surprising, the only case with varices had one valve on each side. The terminal segment in both genders was almost identical and the venous course was similar. Precisely: men frequently had (N=11) less valves then women (N=4).



Now a very important nuance that is still missed in the medical field and research today that I picked out of this study is that pelvic congestion syndrome and varicocele are the exact same thing.


In females it is often called pelvic congestion syndrome and ovarian vein reflux and in men almost always varicocele. In both men and women however, the clinical presentation is exactly the same. This leads me to believe that the cause in female and male are the same too.



In-fact, multiple medical sources mention that varicocele is the same condition as pelvic congestion syndrome. An academic example of this is Professor Mark Whiteley MBBS MS FRCS, a renown venous surgeon and phlebologist from the United Kingdom who is also the founder of the Whiteley Clinic which specializes in varicose veins treatment. He mentions this in the following presentation:

https://www.youtube.com/watch?v=XobdbvQWbIc

The following medical source also mentions varicocele as the same thing as pelvic congestion syndrome:
https://www.physio-pedia.com/Pelvic_Congestion_Syndrome

As well as this New York City based clinic which specializes in pelvic congestion syndrome, mentioning it treats both men and women for the condition:
Pelvic Congestion Syndrome (PCS) - Pamela Morrison Pelvic Pain Physical Therapist, P.C.


With that being said, the realization that pelvic congestion syndrome and varicocele are one in the same, opens up a big stockpile of literature and research for the average varicocele investigator like me. Searching for "pelvic congestion" on PubMed alone finds you 503 studies and "ovarian vein reflux" 65 studies. Searching for "pelvic congestion syndrome" finds you 303 studies. Pelvic congestion syndrome also has some confirmed causes: Nutcracker syndrome, May-Thurner syndrome and Budd-Chiari syndrome and external compression due to tumor (including fibroid, endometriosis) or scarring.


Furthermore, I would like to expand on Nutcracker syndrome as being a cause for varicocele, much more often than previously thought. This 2010 study describes the following:


Varicocele and nutcracker syndrome: sonographic findings. - PubMed - NCBI


OBJECTIVE: Varicocele is a vascular lesion commonly associated with infertility. Its etiology is only partly understood; hence, the purpose of the study was to establish its correlation with intrinsic anatomic differences and nutcracker syndrome.


METHODS: A total of 93 patients with varicocele and 76 patients without varicocele were enrolled. The diagnosis of varicocele was based on physical examination, followed by sonographic evaluation of the hilar portion and aortomesenteric portion (AMP) of the left renal vein (LRV). The anteroposterior diameter in millimeters and peak flow in centimeters per second in each region were measured.


RESULTS: A total of 28 patients with the nutcracker syndrome were identified in the study group (30.10%), and 2 were identified in the control group (2.63%). The mean diameters of the hilar portion and AMP of the LRV were significantly different in varicocele-affected patients compared with the control group (P < .0001 for both). The mean peak velocities in the hilar portion and AMP were significantly different in patients with varicocele (P < .0001). Patients with varicocele and nutcracker syndrome did not have a significant difference in either the hilar or AMP diameter compared with patients with varicocele without nutcracker syndrome. They had a significant difference in both the hilar and AMP peak flow velocity (P = .0001 for both).


CONCLUSIONS: Our findings indicate that nutcracker syndrome is a frequent finding in varicocele-affected patients and should be routinely excluded as a possible cause of varicocele. In addition, intrinsic anatomic differences in the AMP and hilar portion of the LRV could be directly responsible for the onset of varicocele.



As a footnote I would like to add the following segment of a 2015 study on varicocele in regards to valves not being the cause which further ties into the aforementioned studies:


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4492060/

...First, venous valves are more commonly absent on the left-side, with one study finding valves absent in 40% of left spermatic veins, but absent in only 23% of right spermatic veins.11However, 26% of patients with varicocele have competent valves, making the absence of valves an unlikely unifying cause of varicocele.12...



A male friend of mine with varicocele had two MRIs done, one on his pelvis and one on his lumbrosacral spine. The results were noted as the following:


"Extensive bilateral varicoceles extending into the pelvis and bilateral pelvic sidewall.
"Note is made of prominent pelvic veins. Engorgement of the seminal vesicles and tubules."


Not surprisingly, these findings are identical to the findings on a MRI of a female with pelvic congestion syndrome in regards to the tubules:

image003.jpg

Source of image: https://veintreatment.weillcornell.org/varicose-spider-veins/pelvic-congestion-syndrome


Furthermore, a professional of the Sheen Vein Institute says the following:

https://www.veindirectory.org/quest...-therapy-with-pelvic-congestion-syndrome-1608

"Answered by The Sheen Vein Institute


Pelvic congestion syndrome is due to the presence of varicose veins inside the pelvic cavity. The result is congestion and often discomfort due to the pressure and irritation in that area."



This leads me to believe there is a possible cause found for PCS/varicocele in the pelvic floor. Upon further investigation I found out that the diaphragm is connected to the pelvic floor physically, by the following presentation:

https://www.youtube.com/watch?v=e_v0Sfi0GqI

After trying out diaphragmatic breathing while standing, especially holding in my breath, I discovered it makes the varicocele disappear for 90 to 98%. I previously already knew that a squat called Malasana, hindi squat or Garland pose makes my varicocele disappear for 100%, and stretch exercises for the adductor muscles also make my varicocele dissapear 100%. This is probably due to the stretching effect on the pelvic floor muscles.

I had a slower urinary flow for a year and a half after I developed varicocele, and this is caused by the pelvic floor muscles too:
https://urology.ucsf.edu/patient-care/adult-non-cancer/female-urology/female-voiding-dysfunction

All in all my suspicions that the pelvic floor muscles are the root cause of varicocele/PCS are highly supported by the previous findings and another cause in a lot of cases would be Nutcracker syndrome with these two causes as the most common causes, the pelvic floor muscles being the most. A role for another muscle or muscle group like the psoas muscles, shown in an anatomical variant to have the spermatic vein run through it, being the cause is not ruled out. The other fewer causes would be the syndromes named earlier and cancer, cysts and scarring. The urologists consensus that defective valves are the cause is unsupported by scientific evidence.


TL;DR

Varicocele is not caused by defective valves as urologists universally claim. The urologists are wrong. And this has been proven by scientific evidence.

Pelvic congestion syndrome and varicocele are the exact same thing, there is no difference between them. They are the same condition. This is confirmed by multiple medical sources and a renown academic venous surgeon called Professor Mark Whiteley.

All the literature and information out there on pelvic congestion syndrome, which also goes by the name ovarian vein reflux and pelvic congestion, are also applicable to varicocele. A PubMed search for "pelvic congestion syndrome", "pelvic congestion" or "ovarian vein reflux" lead to hundreds of unique articles and studies on the condition.

Varicocele/Pelvic congestion syndrome is caused by varicose veins in the pelvic floor, which are caused by your pelvic floor muscles. The pelvic floor is physically connected to the diaphragm. Diaphragmatic breathing (also known as belly breathing) leads to disappearance of the varicocele. Especially when holding your breath as you've breathed through your belly. (with your belly out) This test serves for a good test to check if your varicocele is caused by your pelvic floor muscles.

A second cause for varicocele is Nutcracker syndrome. This needs a seperate ultrasound and/or MRI of your upper torso near the kidney area to be ruled out. This cause is much more common than previously thought according to scientific research.

Other more rare causes for varicocele are several rare syndromes where a vein is constricted, blockage by cancer, cysts or scarring.

Varicocele is not caused by defective valves, the urologists are wrong.
 
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Excellator

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Well I just judge from the testes sag and slight ed and the pain throb. Judging from those things being gone I would conclude yes but I havent gone to the doctor to check since the symptoms are finally gone i'm gappy
The reason why bromelain helps your varicocele is because it tips the balance of fibrin creation and breakdown in favor of breakdown, which is favorable for veins, as varicose veins are among more caused by more fibrin being created than being broken down. Fibrin is what is used for the blood to clot.

Bromelain also helps dissolving scarring, which is also a cause for varicose veins and varicocele through blockage of one or multiple veins.
 
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mohamedlamine

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Thank you for your effort and for all the information you are sharing with us.
I will try a stretch routine since i have a hard flaccid already and i will keep you updated.
 

Excellator

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I want everyone that wants to heal his varicocele to research Ocotillo tincture, and try this out.
 

xosuit

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The reason why bromelain helps your varicocele is because it tips the balance of fibrin creation and breakdown in favor of breakdown, which is favorable for veins, as varicose veins are among more caused by more fibrin being created than being broken down. Fibrin is what is used for the blood to clot.

Bromelain also helps dissolving scarring, which is also a cause for varicose veins and varicocele through blockage of one or multiple veins.

Thanks for confirming this, I've shared the same info you have but i think a lot of ppl were on the fence. So you hopefully more ppl are convinced to try the enzymes. Pancreatin seems to have been much more effective than bromelain as no symptoms have returned ever for months without me taking anything. But it has to be on empty stomach. Anyway thx for the info.
 

Bisquick61

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I do not suffer with this. But this is great information for those that do. Thank for all of the research
 

Excellator

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Thanks for confirming this, I've shared the same info you have but i think a lot of ppl were on the fence. So you hopefully more ppl are convinced to try the enzymes. Pancreatin seems to have been much more effective than bromelain as no symptoms have returned ever for months without me taking anything. But it has to be on empty stomach. Anyway thx for the info.

Did Pancreatin fully heal your varicocele? Is there no bloating left in the vein bundle at all? Does it feel exactly like the right side one?
 

Pegasus

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So when I advised Hindi squat ,rk etc long back I was onto something.
 

Nik_19

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Nikitis, I know you have changed nickname, indeed I dont understand who you are anymore ahah.
Anyway guys I have thought that we could help each other a lot more if we all join this group I just created on telegram (which is an end-to-end encrypted chat, meaning it's censorship resistant, messages are encrypted, and no one can read your telephone number but only your username).
here's the link to join: https://t.me/joinchat/I46xjhREIah7V5LkVTYOTg I think this will help us to communicate faster and to get to a solution of the varicocele problem by chatting.
 

Nik_19

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- manual detorsion of mild testicular detorsion (this one was very important) @excellator honestly I am very worried to do it, and I annot say it I have or not a mild testicular torsion.
 

Nik_19

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have you finally tried bromelain?
The reason why bromelain helps your varicocele is because it tips the balance of fibrin creation and breakdown in favor of breakdown, which is favorable for veins, as varicose veins are among more caused by more fibrin being created than being broken down. Fibrin is what is used for the blood to clot.

Bromelain also helps dissolving scarring, which is also a cause for varicose veins and varicocele through blockage of one or multiple veins.
 

Robdog22928

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Is anyone still trying to cure their varicocele wth Hindi squats and rks?
 

Nik_19

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today I have started to do them again. The problem in my opinion is that the varicocele often starts from the renes (nutcracker syndrome), so my goal is to fix that and I think varicocele will be fixed as well. Maybe I should try bromelain and both these problems will be fixed
 

Nik_19

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Yeah bromelain dissolves blood clots. Which is a good thing honestly. But you dont want your blood too thin. But then again it would take more than 3000 gdu for that to happen. I wouldnt worry too much HF83 I two 2400gdu x2 so 4800gdu in total at once sometimes twice in a day since last year and im still here. But if you are ona blood thinner or thickner then yeah from the docs then bromelain would amplify the thinner and interfere with the thickner .Other than that you'll be fine. Just dont take more than 2 or 3 a day preferably 2 is fine.

Man, I was doing some calculation and 4800gdu in a day seems not possible to me, considering that 1g contains 2400 gdu and a pack contains 0.5g. It means in a pack of bromelain there are 1200 gdu. so to take 4800 gdu every day you would need to eat 4 bromelain packs every day.

Correct me if I am wrong, please
 

Nik_19

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Thanks for confirming this, I've shared the same info you have but i think a lot of ppl were on the fence. So you hopefully more ppl are convinced to try the enzymes. Pancreatin seems to have been much more effective than bromelain as no symptoms have returned ever for months without me taking anything. But it has to be on empty stomach. Anyway thx for the info.
I think it's the first time you mention pancreatin. Please be specific. Should I try with the bromelain or the pancreatin?
Previously you said that the bromelain had a permanent effect, but now you are saying the permanent effect is due to the pancreatin. Could you please explain, because I don't know what to buy.
 

mohamedlamine

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I've started a stretch routine recently and some exercices feels like they are working ( hindi squats + laying on my back and connect the bottom of my feet, knees bent and let my legs hang to both sides "i can explain more if you are interested" )
I'm still exprementing with exercices and i'm willing to be consistent with them as long as i can before i report the last result to you guys.
 

Nik_19

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I've started a stretch routine recently and some exercices feels like they are working ( hindi squats + laying on my back and connect the bottom of my feet, knees bent and let my legs hang to both sides "i can explain more if you are interested" )
I'm still exprementing with exercices and i'm willing to be consistent with them as long as i can before i report the last result to you guys.
I would like to hear more if the varicocele continue on shrinking
 

Nik_19

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Just got the bromelain!
Will keep you guys updated.
I'll write here the results every other week or every month.
 

HF83

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Does anyone else get strong smelling urine from Bromelain?