Varicocele diagnosis according to ICD 10. Varicocele: main signs of the disease and treatment. How to treat varicocele on the left testicle

What is the code for varicocele according to the International Classification of Diseases? According to ICD-10, varicocele code I86.1 is varicose veins of the scrotum.

What is ICD-10? ICD 10 is the international classification of diseases 10th revision. This classification and codes are used in absolutely all areas of medicine, that is, urology is no exception.

According to statistics provided by the World Health Organization, the disease is most common among adolescents. Statistics also say that approximately 40% of patients who do not treat the disease in a timely manner develop infertility.

Prevalence and causes of the disease

Among which segments of the population is the most common pathology such as varicocele, ICD-10 code I86.1? According to statistics, the disease is much more often diagnosed in men during adolescence.

Moreover, varicose veins of the spermatic cord are much more common in the left testicle. Doctors explain this by the anatomical features of the circulatory system. In general, varicocele can be congenital or acquired.

This pathology is very common among men suffering from secondary infertility. Moreover, if varicocele is not treated in a timely manner ICD-10 I86.1, infertility may develop. Therefore, doctors strongly recommend seeking help in a timely manner.

There are many causes of the disease:

1. Hard physical labor. The acquired form of varicocele is often the result of monotonous work that requires heavy lifting. However, there is another side to the coin. Men who lead a sedentary lifestyle are susceptible to venous congestion, which means they can also develop varicocele.
2. The presence of chronic diseases of the genitourinary system. These include prostate adenoma, prostatitis, orchitis, vesiculitis and many other diseases.
3. Addiction to alcohol and smoking. Bad habits have a detrimental effect on the functioning of the circulatory system. And with any disturbances in blood flow, the likelihood of dilatation of the veins of the spermatic cord increases significantly.
4. Underdevelopment of the inferior vena cava.
5. Pathologies of the valve apparatus.
6. Congenital connective tissue deficiency.

Doctors also identify indirect reasons. What it is? As you know, varicocele can appear due to increased intra-abdominal pressure.

And intra-abdominal pressure, in turn, increases with excessive tension in the abdominal muscles, a chronic cough, or prolonged constipation.

Stages and symptoms of the disease

In total, there are 4 stages of varicocele – zero, first, second and third. Each stage has a number of its own characteristics. Varicocele according to ICD-10 I86.1 of zero degree practically does not manifest itself at all. Only occasionally can a man be bothered by pain in the scrotum, which goes away on its own over time.

The disease cannot be detected visually at the zero stage. The scrotum is not lowered, there may be no seals, and the patient does not feel pain upon palpation (only occasionally mild discomfort).

Grade 1 varicocele manifests itself as nagging pain in the scrotum. Moreover, the pain syndrome intensifies somewhat during sexual intercourse. During physical activity, the patient also feels discomfort. Grade 1 varicocele cannot be visually detected. On palpation, the dilated veins of the spermatic cord are not felt.

The second stage has a more pronounced clinical picture. The patient complains of constant pain in the scrotum, which increases significantly during sexual intercourse or physical activity.

It becomes possible to palpate pathologically changed areas during the initial examination of the patient. But externally dilated veins are not visible.

The third stage of varicocele has a pronounced clinical picture. The vessels begin to weave into knots. The patient suffers from pain in the scrotum and a feeling of heaviness when walking. The pain becomes bursting.

The scrotum becomes deformed and acquires a bluish-purple tint. Hyperthermia and even prolapse of the scrotum are often observed.

Diagnosis of pathology

When the first symptoms of varicocele appear, it is strongly recommended to consult a doctor. After all, it often happens that varicose veins of the spermatic cord are far from the only disease.

Very often, the patient is simultaneously diagnosed with varicose veins in the legs and varicocele, orchitis and varicocele. There can be a huge number of such “combinations”.

To make a final diagnosis, the patient needs to undergo a series of tests:

• Ultrasound examination and Dopplerography of the scrotum.
• Visual inspection and palpation of the testicle.
• Blood analysis. Moreover, both a general and biochemical blood test can be prescribed.

A spermogram is required. This analysis is necessary because when the veins of the spermatic cord dilate, the quality of sperm decreases. If the spermogram is below normal, then the diagnosis is complemented by other procedures.

Based on the diagnostic results, the physician determines the severity of the pathology and chooses the optimal treatment tactics for a particular patient.

In the presence of secondary pathologies, for example, prostatitis, hemorrhoids, adenoma, orchitis, additional diagnostic procedures are used.

Treatment and prevention of varicocele

Every tenth patient does not turn to doctors in a timely manner, as a result of which he develops infertility and other complications. Therefore, you need to contact urologists in a timely manner.

To treat varicocele, surgical methods are usually used, especially if the disease has progressed to grade 2-3 severity. The initial stages can be treated with medication, but such therapy is not always successful.

To get rid of varicocele, the patient may be prescribed:

1. Operation according to Ivanissevich. This procedure is the most common. But the manipulation has a minus - a high probability of relapse (about 30-40%). The essence of treatment comes down to ligation of the affected testicular vein.
2. Sclerotherapy. The essence of the procedure is the introduction of a sclerosing agent into the affected vein. The sclerosant “glues” the vein together and prevents blood flow.
3. Operation Marmara. During the procedure, the surgeon ligates the damaged veins, without affecting the nerve endings, arteries and lymph nodes.

After the operation, the patient needs to undergo a rehabilitation course. During the postoperative period, you should refrain from sexual intercourse, visiting the bathhouse, and lifting heavy objects. The patient is prescribed painkillers and exercise therapy.

How to reduce the likelihood of developing varicose veins of the spermatic cord? This is quite easy to do. First, you need to visit a urologist for a preventive examination. If varicocele is detected in the initial stages, the disease can be treated with medication.

Secondly, it is necessary to promptly treat pathologies of the genitourinary system.

Thirdly, you need to exercise regularly, but it is better to refrain from lifting heavy objects. The most useful sports for the prevention of varicocele are swimming, running, race walking, team sports, and crossfit.

ICD-10 code for varicocele in children - 186.1. This disease is described as varicose veins, which occurs in the lower extremities. And although, basically, this disease manifests itself between the ages of 15 and 30 years, its early inclinations can be identified at a very young age.

This disease is dilatation of veins that occurs in the area of ​​the spermatic cord and in the testicular zone.

Because of this, the functions of the valves are disrupted, which prevent the reverse flow of blood.

The pressure on the vessels increases, which entails their deformation.

This disease affects 20% of the male population of the Earth, and it can be detected early in 8% of men and children.

As a rule, varicocele begins to develop during the period of intensive growth of the boy, which occurs at 14-15 years.

The disease itself is not dangerous and cannot be fatal.

However, its consequences are serious. If varicocele is not treated in the initial stages, it appears, but if the disease is neglected, it can contribute to the formation of cancer cells.

Varicocele in children

The average age at which a varicocele develops varies from 15 to 25 years. It is during this period that active maturation occurs in a man’s body, and sometimes this does not have the best effect on the genitourinary system.

However, this does not mean at all that until the child reaches 14 years of age, parents can be calm. It is possible to identify varicocele even in very young children, with sufficient care.

In an infant

No matter how strange it may be, but Infants are also susceptible to developing varicoceles. True, the reasons for this have not yet been established. Perhaps the imperfection of the venous outflow, which was disturbed at birth, makes itself felt in this way.

Children at this age exhibit a developmental defect in the internal or external spermatic vein. Blood stagnates in it, its outflow does not occur, which is why hypoxia of testicular tissue develops.

As a rule, serious factors can affect such a disease, namely, congenital weakness, which was identified in the vascular network, which is abundant between the veins.

The imperfection of the valves of the testicular system also affects.

Varicocele in a child can be detected in the maternity hospital.

Doctors easily recognize this disease based on the following factors.

These include:

• increased testicular temperature;
• their retraction;
• tissue hypoxia;
• dilated veins;
• differences in size;
• as well as a change in the pattern of veins.

What does this mean if a varicocele is detected at an age older than infancy? Let's look further.

In teenagers

If we look at statistics, varicocele can very rarely be recorded in children under nine years of age, and already between the ages of 10 and 14 years it occurs in 20% of adolescents. Agree, the numbers are impressive, but what influences such a sharp jump in data?

If we turn to physiology, then in a period of time from 10 to 15 years, the boy’s genitals increase in size. As a rule, the increase occurs abruptly, and over a fairly large distance from 5 to 15 - 20 cm.

If the genitourinary system is ready for such development, then the blood vessels and venous network are not. She cannot keep up with rapid growth and cannot transform to meet the new needs of the body.

Deformation occurs that is why one of the testicles may not have enough nutrition, so a partial sign of varicocele is a difference in volume.

If the main reason for the development of varicocele in adults is due to the fact that the functioning of the vascular network and the circulatory system as a whole is disrupted, then the reason for varicocele in a boy of 12-14 years old and small children lies in rapid growth, so parents should be attentive to how quickly it grows their child, and do not delay a scheduled visit to the urologist.

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Varicocele - photos in children:

Reasons for development

The development of varicocele in children and adolescents is influenced by many factors, so you should not attribute the acquisition of the disease to a sharp jump in growth and development.

Doctors also identify other reasons that may affect the boy’s health. Let's take a closer look to eliminate these risk factors for your child..

1. If someone in the male line of the family has a varicocele, then this factor may negatively affect your child.
2. Birth injuries that affected the weak walls of blood vessels. If the birth was complicated, congenital deformities may also result.
3. The development of varicocele can be caused by various mechanical damages.
4. No matter how strange it may be, respiratory tract diseases that are accompanied by cough can affect the development of the disease.
5. Constant strong arousal without discharge, that is, sexual intercourse, affects the expansion and contraction of veins, which leads to deformation.
6. Lifting weights.
7. Constipation.
8. Increased temperature in the testicular area.
9. Blood condition.
10. Valve dysfunction.
11. Physical exercise.
12. Tumors.
13. Lack of oxygen saturation of the body.

You can learn more about the causes of the disease.

Symptoms

It is important for parents to pay attention to studying in order to suspect this kind of illness in their child in time.

The first signs of the disease become visible when its active development begins.

1. The main symptoms of varicocele development are pain that is aching or even pulling in nature, manifested in the scrotum and also in the groin. Pain may not always appear, but only during heavy lifting or physical activity.
2. Itching, burning sensation and other discomfort in the scrotum area is the cause of the disease.
3. The scrotum may increase in size.
4. Uncharacteristic dilatation of veins in the genitourinary system also indicates the disease.

Unfortunately, varicoceles are often in the initial stages is asymptomatic or the child, due to his age, cannot explain his discomfort to his parents.

Over time, without proper treatment, pain in the scrotum area may increase, along with a growing sensation of itching and burning.

The veins expand, but the blood, on the contrary, can stagnate. This leads to the formation of painful lumps that do not resolve, but clog the veins, thereby making it difficult for the body to saturate with oxygen. Unfortunately, only at this moment can parents and the child pay attention to the presence of the disease and take action.

Stages

It is used both at the first and third stages of the disease, however, this operation is not recommended for children due to the high level of possibility of injury. It is performed under general anesthesia.

One of the most effective operations to eliminate varicocele. It is done under local anesthesia. Doctors leave a small incision on the scrotum, and penetration into the abdominal cavity occurs. The affected vessels are excised and then stitched back together. As a rule, after such an operation the fewest complications are observed.

Another type of surgery is . The result of such an operation is excision of the vein that was affected by the varicocele. The operation is performed through three punctures into which tubes are inserted.

Through one of them, gas is introduced into the abdominal cavity, and the others are video surveillance and an instrument. This method is very effective, but it takes place under general anesthesia, which can negatively affect the fragile health of the child.

Which method of surgical intervention for varicocele in a boy depends only on the parents and on the attending physician, who can help you make a choice in one direction or another, depending on your individual situation.

Pay close attention to your child's health, do not neglect scheduled examinations by a urologist. Perhaps diseases that are just beginning to develop in the body, if not properly treated, will leave their traces, thereby depriving your child of the joy of fatherhood.

Varicocele- varicose veins of the spermatic cord, occurs in 15% of men. It is usually detected in adolescents during a medical examination. It is less commonly diagnosed in adult men during examination for infertility (detected in 30% of cases). In 90-95% of cases, varicocele develops on the left.

Code according to the international classification of diseases ICD-10:

• I86.1

Causes

Etiology and pathogenesis. The main causes of left-sided varicocele are considered to be anatomical features: the left testicular vein flows into the left renal vein, and the right one connects with the inferior vena cava immediately below the right renal vein. As a result, several factors can act: the absence of valves in the vein leads to the formation of pathological retrograde blood flow with increased pressure in the left renal vein; the length of the left vein is greater, and therefore greater hydrostatic pressure is created on the left, even with normal pressure in the renal vein. Impaired blood flow and hypoxia lead to degenerative changes in Sertoli cells (sperm formation) and Leidig cells (testosterone production). A simultaneous increase in temperature also disrupts spermatogenesis. An isolated varicocele on the right develops, as a rule, due to compression of the right kidney by the tumor (right-sided varicocele is considered a pathognomonic symptom of the tumor).

Classification. I degree - varicose veins of the spermatic cord are located above the lower pole of the testicle. II degree - varicose veins of the spermatic cord descend below the lower pole of the testicle, there is no testicular atrophy. III degree - varicose veins of the spermatic cord descend below the lower pole of the testicle, there is testicular atrophy.

Symptoms (signs)

Clinical picture. In the initial stages, the disease is asymptomatic; varicoceles are detected by chance during examination. With pronounced dilatation of the veins, a feeling of heaviness and pain appears. Varicocele can cause testicular dysfunction, which can also lead to infertility.

Diagnostics

Diagnostics based on clinical examination. Venography is considered optimal. In the case of bilateral varicocele, a thorough examination is necessary to identify vascular abnormalities (ultrasound, CT, venography, angiography).

Treatment

Treatment surgical. The most common Ivanissevich operation is ligation of the left testicular vein in the retroperitoneal space. Key points of the operation: isolation of both veins (2 trunks go to the level of the sacroiliac joint), emptying of blood from varicose veins in the scrotum after crossing the testicular vein. Physiologically justified, especially in the presence of vascular anomalies that cause increased pressure in the renal vein, is the imposition of a vascular anastomosis between the proximal segment of the testicular vein and the inferior vena cava system (microsurgical technique is required). Complications of surgical treatment arise when the surgical technique is violated: orchitis, funiculitis, hydrocele (when excision of veins at the level of the spermatic cord), relapse of the disease (the communicating vein is not crossed).

Forecast favorable. Even with pronounced varicose veins and testicular atrophy, infertility does not necessarily develop.

ICD-10. I86.1 Varicose veins of the scrotum

Varicocele is a varicose vein in the spermatic duct and testicle. This pathology is diagnosed in adolescence in 70% of cases. ICD 10 classifies varicocele as code I86.1, namely varicose veins in the lower extremities. Without treatment, this pathology leads to infertility.

Causes

The disease develops due to insufficient functioning of the spermatic cord valve. Under normal conditions, blood flows from bottom to top, but during physical activity or an upright position, the valves are unable to hold back the flow of blood. Due to the increase in pressure in the vessels, venous nodes are formed.

Varicocele ICD-10 refers to varicose diseases

The causative factors of varicocele are:

• connective tissue deficiency;
• pathology of the valve apparatus;
• underdevelopment of the inferior vena cava.

High pressure in the abdominal cavity can provoke the development of the disease. Such stagnant processes are observed with excessive physical exertion, frequent constipation, chronic coughing, and overstrain of the abdominal muscles. These reasons in medical practice are considered indirect.

Varicocele acts as a complication of pathological phenomena in the kidneys, pelvis or retroperitoneum. In clinical practice, this phenomenon is called “secondary varicocele.” In 60-70% of cases, the disease is diagnosed in the left region of the testicle. Sometimes the disease develops simultaneously in two testicles, which negatively affects sperm production. If varicocele develops in old age, you should undergo a thorough examination of other organs of the urinary system. In this case, an obstacle to normal blood flow is a cancerous tumor in the urinary system.

Stages of development

Varicocele (ICD code 10 I86.1) depending on the state of blood flow is classified:

• 0 degree;
• 1st degree;
• 2 degrees;
• 3 degrees.

At certain stages of varicocele, a man develops infertility

The initial stage is characterized by minimal phenomena. There is no pathological dilatation of the veins of the spermatic cord. Changes cannot be detected visually. The patient does not experience discomfort and does not suspect the presence of the disease. The initial stage of varicocele can only be detected using an ultrasound of the scrotum or Doppler examination, which determines the speed of blood flow.

At stage 1, the veins can be palpated in an upright position of the torso. It is not possible to palpate the veins in the supine position. At stage 1, the patient experiences unpleasant sensations in the form of nagging pain in the testicles. With physical activity or prolonged walking, the symptoms worsen. When changing body position, the discomfort quickly passes. However, to confirm the diagnosis, an instrumental study should be performed.

With grade 2 varicocele, the varicose plexus can be palpated in both vertical and horizontal positions. The clinical picture is clearly expressed. The doctor can make a diagnosis after an initial examination of the patient. Ultrasound of the scrotum and Doppler sonography in this case are necessary to clarify the root cause.

There are several reasons as a result of which ICD-10 varicocele develops

At the 3rd stage, dilated blood vessels of the spermatic cord and testicle become visually noticeable. The vessels are woven into numerous nodes. At this stage of development, spermatogenesis is disrupted. The pain becomes constant and bothers the patient even in a calm state. The scrotum becomes enlarged and deformed due to varicose veins.

Symptoms and complications

Varicocele does not go away on its own. Without treatment, the disease only progresses. The nature of the pathology depends on the individual characteristics of the organism. Clinical symptoms appear at stages 1-2 of the disease in the form of hormonal disorders and congestion in the testicular tissues.

Hormonal imbalance manifests itself as:

• erectile dysfunction;
• decreased libido;
• deterioration in sperm quality.

Stagnant processes are quite easy to identify. A man feels discomfort when walking and a nagging pain in the scrotum. Symptoms intensify in the hot season or after active movement or physical activity.

Varicocele manifests itself in the form of dilated veins that form a special pampiniform plexus on the testicle

At stage 3, the nature of the pain changes to acute and sharp. A bursting pain appears when emptying the bladder. Analgesic drugs are not able to relieve severe pain. In some cases, the patient may complain of a burning sensation or excessive sweating in the testicular area. The scrotum becomes deformed and acquires a bluish-purple tint. Sex becomes impossible due to pain in the external genitalia.

One of the complications of varicose veins of the seminal canal and testicle is infertility. Excessive pressure negatively affects the functioning of the testicle and sperm production. Without treatment, the temperature in the scrotum rises, free radicals arise that destroy the vessels of the testicle, and a reverse reflux of active substances from the adrenal glands and kidneys occurs. All these factors cause infertility.

Varicocele can lead to testicular atrophy. The volume of the affected testicle is 25% less than that of a healthy one. This leads to sagging of the scrotum and impaired sexual function.

If you experience pain of any kind in the testicular area, you should immediately consult a doctor.

Treatment

Drug therapy for varicocele (ICD code 10 I86.1) is ineffective. The disease requires surgical intervention. In modern medicine they carry out:

• Open surgery.
• Operation Marmara.
• Sclerotherapy.
• Laparoscopy.
• Microsurgical operation.

A medical diagnosis of the presence of ICD-10 varicocele can be made as a result of a routine examination by a specialist

Traditional open surgery is performed using local anesthesia. The surgeon makes a small incision in the abdominal cavity, 3-5 cm long. Through the incision, the affected varicose plexus is ligated. At an advanced stage, it is completely removed. The risk of developing a re-exacerbation is 30-40%.

The Marmara operation is safe and effective. An incision is made in the groin area, 2-3 cm long. Through the incision, the surgeon gets to the dilated vessels. Using microscopic equipment, it ties damaged veins without affecting the nerve endings, lymph nodes and arteries. The recovery period after surgery is minimal. The patient is discharged on the same day. The patient quickly returns to his normal lifestyle.

The principle of sclerotherapy is that the femoral vein is punctured in the groin. Through a puncture, the doctor injects a sclerosing substance, which prevents blood from flowing through the affected vessel. This type of operation is mainly performed for bilateral forms of the disease.

During laparoscopy, 3 incisions are made in the abdominal cavity. Endoscopic instruments and a camera are inserted into them. Titanium staples are applied to the affected veins. Laparoscopy is performed under general anesthesia. The operation lasts 30-40 minutes. This type of surgery is minimally invasive, so the recovery period is minimal.

Microsurgery is performed under general anesthesia. The surgeon makes a small incision in the groin area. The principle of the operation is to transplant the testicular vein into the epigastric vein. Blood circulation to the testicle is restored. Relapses after the procedure are extremely rare.