A varicocele is an abnormal enlargement of the pampiniform venous plexus in the scrotum. This plexus of veins drains blood from the testicles back to the heart. The vessels originate in the abdomen and course down through the inguinal canal as part of the spermatic cord on their way to the testis. Varicoceles occur in around 15% to 20% of all men. The incidence of varicocele increase with age. Signs and symptoms
Varicocele might be noticed as soft lumps, usually above the testicle and mostly on the left side of the scrotum. Right-sided and bilateral varicocele does also occur. Men with varicocele can feel symptoms of pain or heaviness in their scrotum. Large varicoceles present as plexus of veins and may be described as "bag of worms". Varicocele is sometimes discovered when investigating the cause of male infertility. Cause
There are three main theories as to the anatomical cause; the first has to do with the geometry of the veins, wherein the vein on the left side connects to the larger outflowing vein at a right angle, which tends to fail; the second is that valves that are supposed to prevent backflow fail (venous insufficiency); the third is due to excessive pressure in upstream arteries, created by nutcracker syndrome. Pathophysiology
Often the greatest concern with respect to varicocele is its effect on male fertility. The relationship between varicocele and infertility is unclear.
Description
Bitlis preserves more medieval and traditional architecture than any other town in eastern Turkey. They are of a high quality and are mostly constructed from locally quarried light-brown stone, sometimes called Ahlat stone. The town contains a large number of late-medieval Islamic buildings in the form of mosques, madrassas, and tombs. Also commercial buildings such as "Hans Caravanserais. Commissioned mostly by its local Kurdish rulers, the architectural style of these buildings is very conservative and similar to much earlier Seljuq-period structures. Important monuments include the 12th-century Ulu Mosque with its 15th-century minaret, and the Gokmeydani Medresesi and Sherefiye Mosque from the sixteenth century. Until 1915 there were five Armenian monasteries and several churches in Bitlis – only a 19th-century Armenian church survives, now used as a warehouse.Bitlis is also notable for its many old houses. These are built of cut stone and are often large and impressive structures. Most have two stories, but three stories are also found. Ground floors were generally intended for storage and stables, with the residential quarters on the upper floors. Ground floor rooms have few windows, upper floors are well lit. Roofs are flat and covered with beaten clay. Unlike traditional houses in nearby Erzurum or Van, Bitlis houses do not have bay windows and balconies. Gallery
Demographics
According to Encyclopædia Britannica Eleventh Edition from 1911, the town had 35 thousand people with 12 thousand Armenians, the rest being Kurdish. Climate
Bitlis has a dry-summer humid continental climate according to the (Köppen climate classification: Dsa, or Trewartha climate classification: Dca).