25, 5, 2022

Complications and Causes of Varicoceles

2022-04-29T16:58:30-07:00

What are Varicoceles?

A varicocele is a term used to describe abnormal enlargement of the veins within the scrotum. The veins carry blood from the various body organs back to the heart. Typically, veins have valves that prevent blood backflow. When the valves in the veins within the scrotum don’t work as they should, blood tends to collect in the scrotum, leading to varicoceles.

While varicocele is very common, it is not life-threatening. In fact, research shows that about 15 percent of all adult men have varicocele. For most men, the condition will go unnoticed throughout their life or does not cause any complications. Although the condition is not dangerous, varicocele is a common cause of low sperm production and reduced sperm quality, leading to infertility. Varicoceles can also lead to reduced testosterone production and scrotal discomfort. The condition often does not need treatment until there is a reason for concern about the associated problems. Fortunately, varicocele is easy to diagnose and treat.

 

 

 

Complications and Causes of Varicoceles

 

Unfortunately, although the condition is not life-threatening, it can also lead to several unpleasant complications.

  • Atrophy (shrinking of the affected testicles)

The testicles are made of sperm-producing tubules. Varicoceles damage these tubules, making the testicles soften and shrink.

  • Infertility

The condition also causes the local temperature around or in the testicles to be too high, affecting sperm formation

 

Causes

Medical practitioners are not sure of the leading cause of varicoceles. However, doctors agree that the condition forms when there is a problem with blood flow in the spermatic cord. The problem develops when the valves in the veins do not function properly and allows blood to flow back. As a result, blood pools in the veins causing them to dilate. When the condition is common in adults, it can also develop in teens during puberty. The testicles usually require more blood than usual during this growth cycle. This condition can lead to problems in the veins, preventing the blood from flowing where it should.

For more information on vein and vascular treatment please visit our YouTube Channel. 

 

Complications and Causes of Varicoceles2022-04-29T16:58:30-07:00

Varicocele Diagnosis and Treatments

2022-04-29T16:50:34-07:00

Varicocele Diagnosis

 

Your doctor will perform a thorough physical examination, which might reveal a non-tender mass above the testicles to diagnose varicoceles. When the mass is large enough, it feels like a bag of worms. When the varicocele is small, the doctor might request you to stand, take a deep breath and hold it while you bear down. This technique will help the doctor to detect any abnormal veins enlargement. Your doctor may also order a scrotal ultrasound. The test uses high-frequency sound waves to create a precise image of the structure of the scrotum. The test is also helpful in helping the doctor rule out other reasons that could be causing the problem in the scrotum.

 

Treatments for Varicocele

 In most cases, varicoceles treatment is not necessary. Most men with varicoceles do not    experience   fertility issues. However, if the condition is causing pain, testicular atrophy, or infertility, you can benefit.

In most cases, varicoceles treatment is not necessary. Most men with varicoceles do not experience fertility issues. However, if the condition is causing pain, testicular atrophy, or infertility, you can benefit from varicoceles treatment. The treatment helps in sealing off the affected vein and redirecting the blood flow into normal veins. In case of infertility issues, varicoceles treatment helps in improving the quality of the sperm and sperm count. The procedure that we perform at LA Jolla Vein & Vascular on varicocele is percutaneous embolization of varicocele embolization.

The primary goal for treatment procedures is to help prevent the backflow of blood from the body to the scrotum, helping in cooling off the testes. Surgical procedures will help restrict the blood flow to the veins leading from the testis to the body. However, not all the veins are sealed off. The vassal vein, which is not subject to the same problems as the other varicose veins, is left open to allow blood to leave the testicles after the procedure.

Some of the clear indications that you need varicoceles repair during adolescence include pain, progressive testicular atrophy, and abnormal semen analysis results. While this treatment helps in improving sperm characteristics, it is not clear whether untreated varicoceles can lead to progressive sperm worsening. 

The common varicoceles treatment options include (La Jolla Vein & Vascular Only Performs Varicocele Embolization):

Percutaneous Embolization (Varicocele Embolization)

    Varicocelectomy

    Laparoscopic Surgery

    Open Surgery

     

 

 Recovery

In most cases, you can go back to your routine after two days of varicose treatment. However, it is advisable to take it easy. Avoid strenuous activities and exercise for about two weeks.People who have undergone percutaneous embolization tend to recover faster. While you may need a day or two off from work, you can return to your workout program in 7-10 days. If the treatment procedure is to help with fertility, your doctor will perform an additional test in 3-4 months. You will be able to see improved results in 6-12 months. It is important to note that more than 50 percent of men who have undergone the procedure have restored their fertility. Additionally, these surgical procedures are also crucial for teens as they help in slowing testicular growth.

 

Varicocele Diagnosis and Treatments2022-04-29T16:50:34-07:00

What are Varicoceles?

2022-04-29T16:39:28-07:00

What are Varicoceles?

A varicocele is a term used to describe abnormal enlargement of the veins within the scrotum. The veins carry blood from the various body organs back to the heart. Typically, veins have valves that prevent blood backflow. When the valves in the veins within the scrotum don’t work as they should, blood tends to collect in the scrotum, leading to varicoceles.

varicocele

While varicocele is very common, it is not life-threatening. In fact, research shows that about 15 percent of all adult men have varicocele. For most men, the condition will go unnoticed throughout their life or does not cause any complications. Although the condition is not dangerous, varicocele is a common cause of low sperm production and reduced sperm quality, leading to infertility. They can also lead to reduced testosterone production and scrotal discomfort. The condition often does not need treatment until there is a reason for concern about the associated problems. Fortunately, varicocele is easy to diagnose and treat.

How do they Affect the Testis?

 

While numerous theories exist, medical experts agree that they cause the veins to carry warm blood from the abdomen down to the testis. Generally, the testis functions properly at around three degrees below the average body temperature. As such, warmblood can affect the testis’ ability to produce testosterone and sperm.

 

For more information on vein and vascular treatment please visit our YouTube Channel.

What are Varicoceles?2022-04-29T16:39:28-07:00

What is Peripheral Arterial Disease (PAD)

2022-04-28T18:54:59-07:00

Peripheral artery disease is a subset of vascular disease,also referred to as peripheral arterial disease (PAD), which develops when excessive plaque buildup on the artery walls causing the narrowing of the arteries.

peripheral artery

The arteries deliver oxygen-rich blood from the heart to other parts of the body. When plaque builds up, it usually restricts the flow of blood, oxygen, and glucose. The obstruction causes pain in the leg as the muscles and tissues are starved for oxygen and other nutrients from the blood. While the pain usually occurs in your legs primarily, it can also be felt in other parts of the body, including your arms, stomach, hip, head, and kidneys.

Are You at Risk for Peripheral Arterial Disease (PAD)?

In most cases, the PAD symptoms are on the lower extremities. You may experience some pain, craping, or tiredness in your hip or leg muscles when climbing stairs or walking. However, the pain usually goes away with rest, only to resurface when you start walking again. Individuals suffering from peripheral arterial disease are at a high risk of coronary artery disease, stroke, or heart attack. Even worse, if left untreated, the condition can lead to gangrene and amputation.

 

Peripheral Arterial Disease – Symptoms

 

The most common symptom of Peripheral arterial disease is claudication. The fat and cholesterol build up on the artery walls cause a lack of blood flow, causing a condition referred to as ischemia. Ischemia is a condition that results when there is a greater demand for oxygen than the supply.

Claudication is a condition that causes cramping in the legs and buttocks. As mentioned, the pain and clamping flares up when you start to walk and subsides when you rest. Intermittent claudication affects about 50 percent of individuals suffering from peripheral artery disease. Some of the other common symptoms include loss of hair around the ankles, numbness or coldness in your feet.

Pain and cramping while walking may lead to a more sedentary lifestyle, meaning that the individual will burn few calories and add weight. An increase in weight also increases cholesterol, blood pressure, and other heart disease risk factors. The claudication severity often varies from mild discomfort to debilitating pain, making it hard for you to walk or perform other types of physical activities. 

PAD

Other common symptoms of the peripheral arterial disease include;

  • In extreme cases, an open wound or ulcer occurs on your toes or feet. These extreme cases lead to non-healing ulcers. The ulcer can progress to gangrene, making it hard for you to walk. In such a scenario, immediate medical attention is necessary.
  • Weakness or numbness in your legs
  • Coldness in your lower feet, especially when you find one foot is colder than the other one.
  • Experiencing pain in your feet or toes while you are resting
  • Sores on the legs, feet, and toes that do not heal
  • Slower toenails growth
  • Change in the color of your feet
  • Erectile dysfunction in men can be treated by prostate arterial embolization (PAE), which also treats benign prostatic hyperplasia (BPH)
  • Weak pulse in your feet or legs
  • Developing shiny skin on your legs
  • Having pain in your arms, especially when writing, knitting, or performing manual tasks

As the peripheral disease progresses, you may start to experience pain even when you are lying down. In extreme cases, the pain becomes intense enough to distract your sleep. Resting your legs by hanging them at your bed edge or walking around the room helps stimulate blood flow, relieving the pain temporarily.

 

What is Peripheral Arterial Disease (PAD)2022-04-28T18:54:59-07:00

Treatment for Non Healing Ulcers and Wounds

2022-04-28T17:49:58-07:00

Treatment of Non-Healing Wounds & Ulcers

 

As we’ve seen, there is a very wide range of causes that may contribute to the formation and persistence of non healing ulcers and wounds. It follows that the methods or treatment options at the disposal of healthcare professionals will also be varied. Doctors will discuss the available options with their patients in order to arrive at the best possible options, but the type and severity of the wound will be the decisive point of consideration. These measures include:

Compression Wrapping

Specialized Dressings and Topical Medication

Patient Self-Care and Education

Negative Pressure Therapy (NPWT)

Surgery

Growth Factor Therapy

Debridement (removal of dead tissue)

Compression Wrapping

 

This involves the application of tightly bound wraps to the affected limbs or regions in order to provide support to the vascular system, which might be operating under lower pressure than it should due to the wearing out of the vascular walls and muscles that support the efficient flow of blood to and fro the tissues that need it.

The doctor will start by doing a thorough physical examination. The doctor will also want to learn about your signs, symptoms, personal health history, risk factors, and family health history. The doctor will ask you several questions regarding your medical conditions, such as diabetes, heart disease, and kidney disease. They will also ask you whether you experience pain or cramps in your leg while walking or exercising.

The doctor will also ask about your family history of PAD and other heart diseases. You will also discuss your smoking habit, either current or in the past. After gathering the information, the doctor will proceed to perform a detailed physical examination. The process involves checking for weak pulses in your leg, listening for poor blood flow in the legs using a stethoscope. The physician will also check for any problems on your legs, such as sores, swelling, and pale skin.

Specialized Dressings and Topical Medication

 

Technological progress has made it possible to develop special dressing materials made out of smart polymers that work by adjusting their absorptive qualities depending on the hydration levels of the wound area, among other specialized positive actions. Antibiotics may also be employed topically to non-healing ulcers and these help by reducing the bacterial levels present in the wounds in question while maintaining the optimal levels of environmental moisture suitable for wound repair.

ose PAD. This test usually compares the blood pressure in your arm with the blood pressure in your ankle. The doctor usually uses a pressure cuff together with an ultrasound device. Sometimes, the physician may request you to walk on a treadmill and have the doctor take the readings before and immediately after the exercise. The procedure will help the doctor to capture the severity of the narrowed arteries.

Patient Self-Care and Education

 

There are plenty of measures that patients will be able to implement in the treatment and management if armed with the proper knowledge and aids where required. Regular cleaning and disinfecting of wounds, proper bandage care, manual repositioning of paralyzed limbs, and avoidance of habits that contribute to the incidence or severity of these types of ulcers will be of significant benefit to many.

Negative Pressure Therapy (NPWT)

 

This treatment method works by pulling away the fluid in the wound that nourishes bacteria by the application of negative pressure. It is also known as vacuum-assisted wound closure for this reason. This action will also reduce tissue swelling and bring up fresh blood and nutrients to the problem area, which assist in the healing processes.

 

Surgery

 

In many cases, surgical procedures may be called for to rectify any underlying conditions that might be remedied in this way. Patients with atherosclerosis or blood clots in their vascular system, for example, might undergo surgical procedures to remove these clots or clear built-up cholesterol plaques in their system, thus removing the condition that encourages the formation and persistence of non-healing ulcers.

 

Growth Factor Therapy

 

Growth factors refer to the biomaterials generated naturally in our bodies that play the role of replacing tissues as they are damaged or degraded, as in the case of wounds and infections. These factors include epidermal growth factor, insulin-like growth factor (IGF), vascular endothelial growth factor (VEGF), and more. What your medical practitioner will do is introduce or stimulate these factors directly onto the wound in order to speed up the healing and re-growing processes.

Skin Graft Therapy

Skin grafts taken from donors (cadaver, usually) are another option here referred to as allografts. These grafts provide a covering to the wound without integrating with the host body and work by encouraging and providing a structure for the growth of epithelial cells. Severe cases might not be suitable for this intervention, however, and will do better with grafts taken from elsewhere on the patient’s own body.

 

Debridement (removal of dead tissue)

 

Debridement more simply refers to the removal of dead or dying (necrotic) tissue from the site. The goal is to minimize the risk or opportunity for infection by eliminating the necessary medium for bacterial growth and proliferation, which such tissue provides. This is an especially relevant measure undertaken in the fight against diabetic non-healing ulcers, as amputation will usually be carried out in cases where infection has progressed past a certain limit.

This is the idea behind the rather outlandish yet scientifically sound application of maggot therapy in the management and treatment of chronic wounds. Here, live, disinfected maggots will be introduced to the wound by a medical professional. Maggots will happily devour necrotic tissue while not touching healthy tissue. This directly leads to a reduction in the bacterial presence in the wound, thus encouraging rapid healing as well as pain and odor mitigation.

La Jolla Vein & Vascular Treatments

The treatment for PAD has two main goals. One is to manage the symptoms, including leg pain, allowing you to resume your normal physical activities. The second one is to top the progression of atherosclerosis in the body

 

Treatment for Non Healing Ulcers and Wounds2022-04-28T17:49:58-07:00

Symptoms and signs of non healing ulcers and wounds

2022-04-28T17:32:09-07:00

Symptoms of Non-Healing Ulcers

 

As we’ve seen, there is a very wide range of causes of non healing ulcers and wounds that may contribute to the formation and persistence of non-healing ulcers. It follows that the methods or treatment options at the disposal of healthcare professionals will also be varied.

You shouldn’t allow a wound to fester for weeks on end before seeking professional assistance, especially if you fall under one or more of the risk categories we’ve outlined above. The following are some warning signs to look out for:

  • -Darkening or bluish discoloration around the wound edges
  • -Significant pain around the wound that persists without improvement or progressively grows worse
  • -Foul odor or smell emanating from the wound
  • -Swelling and redness emanating from the wound and spreading to surrounding skin and tissue
  • -Continuous leaking, draining, or weeping from the wound

Notice that these symptoms of non healing ulcers and wounds are mostly indicative of infection. This is a good measure as it often indicates a failure of the body’s natural mechanisms to deal with the wound through its normal processes. The rapid and timely intervention will be called for to forestall further tissue damage and complications.

 

ulcer4

Treatment of Non-Healing Wounds

 

Doctors will discuss the available options for non healing ulcers and wounds with their patients in order to arrive at the best possible options, but the type and severity of the wound will be the decisive point of consideration. These measures include:

Compression Wrapping

Specialized Dressings and Topical Medication

Patient Self-Care and Education

Negative Pressure Therapy (NPWT)

Surgery

Growth Factor Therapy

Debridement (removal of dead tissue)

Symptoms and signs of non healing ulcers and wounds2022-04-28T17:32:09-07:00

Varicose Veins and Swelling

2022-04-28T14:48:10-07:00

Varicose Veins and Swelling

Leg swelling (is also known as edema), is a common complaint related to varicose veins and underlying venous insufficiency. It can be present simply from underlying venous insufficiency without visible signs of varicose veins or spider veins. As a result, a venous insufficiency study by duplex ultrasound scanning is part of the recommended work-up for this undesirable symptom. The swelling usually affects the ankles.  Most people with vein-related symptoms, experience progressive swelling throughout the day, that is worse at night time and improved in the morning (they usually wake up with normal appearing legs in the morning but by night-time, shoes may feel tight.) When it is vein-related, it is worse at the end of the day, with prolonged standing, sitting or with air travel, heat and menstruation.  The degree varies from one person to another.

Compression stockings and leg elevation will help reduce swelling.   If the swelling can be attributed to the varicose veins or venous insufficiency, correction of the underlying vein problem will reduce it.

swelling

It is a common symptom of varicose veins and venous insufficiency. The legs often feel heavy. It is common to notice sock lines around the ankles by the end of the day.

Conservative management and lifestyle changes can ease the symptoms of varicose veins and swelling and help reduce complications such as thrombophlebitis (blood clots within veins) and vein rupture, but do not cause the veins to vanish. These measures are helpful if an individual is not a candidate for vein procedures or wishes to delay interventional treatment.

Varicose veins can cause swelling and at La Jolla Vein Care, we offer numerous treatments for our patients. Check out a few of our favorite treatments that help reduce the swelling and varicose veins. Please call our office to schedule a consultation with one of our vein specialists to help in reducing swelling and other varicose vein symptoms.

Varicose Veins and Swelling2022-04-28T14:48:10-07:00

29, 4, 2022

What is VenaCure?

2022-04-15T15:42:25-07:00

VenaCure is an endovenous laser ablation (EVLA) procedure for backwards flow (or “reflux”) in your saphenous vein(s).

VenaCure Laser is also referred to as endovenous laser ablation therapy (EVLT). The great and small saphenous veins are the two main superficial veins of the leg. They run along the inner leg and the back of the leg, respectively.

This minimally invasive procedure can be performed in the office in less than an hour and patients return to their usual level of activity the same day.

How does the VenaCure treatment work?

The skin is numbed with lidocaine, then a tiny wire and the laser catheter are inserted into the vein. The catheter delivers laser energy to the vein wall, causing it to seal shut. The remaining healthy veins continue to bring blood back to the heart.

venacure

The VenaCure procedure is performed with local anesthesia, but many patients elect to use a mild oral sedative (Valium), which is taken after checking in and completing all paperwork.

You will change into a gown and leave underwear on. Depending on the vein to be treated, you will lay on your back or on your belly.  We do our best to make special accommodations (for example, if you cannot lie flat or cannot bend a knee very well) with body positioning and using pillows.  We will do our best to make you comfortable. Then, we will give you the option of watching a movie on Netflix or listen to music. Once you are comfortable, your leg (s) will be prepped with a cleansing solution for the sterile procedure. The doctor will perform an ultrasound to map the vein (s) to be treated.

Then, a numbing agent (lidocaine) will be injected into the skin. In the numb area of the skin, a tiny puncture is made to pass the laser catheter under ultrasound guidance.  Your doctor will then use a needle to administer a combination of cool saline and local anesthetic around the vein.  This solution numbs the vein and insulates it from the surrounding tissue.  Laser energy will then be used to painlessly treat the vein.

Videos of the treatment, as well as after care instructions can be found on our website and our YouTube channel.

What is VenaCure?2022-04-15T15:42:25-07:00

3 Reasons to Wear Compression Stockings

2022-04-15T15:40:11-07:00

Why Compression Stockings:

Compression stockings are an important part of the overall healing process. As a result, you’ll need to wear the stockings following the vein treatments from La Jolla Vein Care to ensure you get the best outcomes. Physiologically, compression therapy increases venous blood flow back to the heart, reduces reflux in diseased veins, increases venous blood flow, reduces elevated water content of the tissue, reduces inflammation, and sustains reparative processes. In short, compression therapy not only improves results after treatment, but it also improves blood flow and reduces symptoms and swelling in the legs. 

 

Compression stockings offer style after vein treatment:

In the past, patients recovering from varicose vein treatments were limited in both mobility and style. After a procedure, patients were required to wear compression stockings in a lovely shade of beige. This might work if you’re looking to hang around the house for a couple months. If you’re ready to live an active life while you heal, however, you can get medical grade compression stockings that are fashionable, stylish, and comfortable.  At La Jolla Vein Care, you get more than a safe and effective alternative to surgery—you get access to customized compression stockings in a variety of styles from the leading brands, including Sigvaris, Medi, ComfoMed, Ames Walker, and JOBST.  While we are more than happy to order beige stockings for you, it’s good to know that you have options—the option to look good, feel good, and heal in style.

Compression stockings help prevent deep vein thrombosis

Stay moving, avoid prolonged sitting. For example, when flying or traveling, the risk of DVT is 1% on a long haul flight (greater than 6 hours).  

To minimize this risk, you should wear compression stockings (which helps increase the blood flow in the legs), stay hydrated, avoid excessive alcohol, use the calf muscles- walk about the cabin and frequently pump the calf muscles by doing foot lifts.

During pregnancy, compression should be worn and after pregnancy, when the risk of DVT is highest (the likelihood of a blood clot postpartum is 40-65 for every 10,000 women).

 

Compression stockings increase athletic performance: 

Compression is known for improving circulation after the removal of varicose veins. But can they improve athletic performance? The answer is a resounding yes. According to Medi, compression sport stockings are clinically proven to increase performance. Over the course of a marathon, for example, running time is reduced by approximately five minutes while the exertion on your muscles is reduced by roughly six percent. Moreover, a study by Technische Universität Dresden reveals that blood circulation is 30% higher at rest after engaging in certain athletic activities when wearing compression sport stockings. So whether you’re a jogger checking out the scenery or a hard-core athlete training for a marathon, there’s something to help you reach your peak.

 

3 Reasons to Wear Compression Stockings2022-04-15T15:40:11-07:00

La Jolla Vein and Vascular welcomes Jodi Hirsch, PA-C

2022-04-23T14:24:17-07:00

La Jolla Vein and Vascular welcomes Jodi Hirsch, PA-C

jodihirsch

Jodi Hirsch PA-C is a board-certified physician assistant who has spent her career specializing in the field of peripheral vascular disease and venous disease.  She gained her undergraduate degree in chemistry and pursued her degree in Physician Assistant Studies from Touro University in NY in 2006. She has spent her professional career in San Diego, previously working in the Department of Vascular Surgery at Scripps. When not at work, she enjoys spending time with her husband and two little boys.

For more information please watch Jodi’s video here.

La Jolla Vein and Vascular welcomes Jodi Hirsch, PA-C2022-04-23T14:24:17-07:00
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