A case study to evaluate Jalaukavacharana in the management of Siraja Granthi with special reference to Varicocele

Varicocele is state of varicosity of testicular veins. It is the more frequent and more discomforting condition seen in mostly in teens or in early adult life of males. Occurs in approximately 15-20% of all healthy fertile males and 40% of infertile males. Varicocele can have destructive effects on mobility, concentration and morphology of sperm and can reduce its DNA integrity and other functions. The treatment protocol in varicocele mainly includes laparoscopic ligation of the testicular veins and embolism of testicular vein under radiological control. The major drawback is surgical intervention. It is done only in advanced stage or when there is severe pain or remarkable oligospermia. There are chances of recurrence. There is no direct reference of varicocele as a separate disease in the classics. But Siraja Garnthi is quoted in all Brihatrayees which has similar etiopathogenesis and clinical presentations. The line of treatment mentioned is Siravyadha. Even Purvarupa of Vruddi mentioned by Acharya Sushruta in Vruddinidhna in Nidanastana, can be considered as varicocele. By considering the site and presentation, varicocele can be co-related with Siraja Garnthi of Vrushana Kosha and the treatment protocol to be followed is Siravyadha. Since the pampiniform plexus and testicular veins are of smaller diameter, Jalakavacharana can be considered. Hence, Jalaukavacharana is carried out to see the effectiveness in Varicocele.