Table of ContentsView AllTable of ContentsWhat Is a Varicocele?Types of SurgeryConditions TreatedPotential RisksDoes Varicocele Surgery Affect Fertility?How to PrepareWhat to ExpectRecovery
Table of ContentsView All
View All
Table of Contents
What Is a Varicocele?
Types of Surgery
Conditions Treated
Potential Risks
Does Varicocele Surgery Affect Fertility?
How to Prepare
What to Expect
Recovery
Varicocelectomyis a surgery used to remove swollen veins inside thescrotum, calledvaricoceles. It is generally performed when varicoceles cause chronicpainorinfertility. It can be used in adult males and boys and is usually performed as a same-day,outpatientprocedure.
Varicocelectomy is a common procedure with a relatively low risk of side effects and complications. When used appropriately for the treatment of chronic testicular pain or infertility, it can be extremely beneficial and safe.
The article explains what varicoceles is and what conditions varicocelectomy can treat. It also describes how varicocelectomy is performed, including the potential risks and what to expect during recovery.
Common and Uncommon Causes of Testicle Pain
Varicoceles often cause no symptoms but can causelow sperm countand decreased sperm quality, leading to infertility. Varicocele is a common condition affecting 15% of adult males, 20% of teenage boys, and 40% of males with infertility.
Varicoceles can cause chronic (persistent) testicular pain in some people, leading to a reduced quality of life.
Causes of Testicular Pain
What Is Varicocele Surgery?
Varicocele surgery, also known as varicocelectomy, is typically performed as anoutpatient procedureand is minimally invasive. The surgery involves tying off, clamping, or blocking the enlarged vein so that blood can be redirected to the testicle.
There are three main types of varicoceles surgery:
Who Is a Good Candidate for Varicole Surgery?
Varicocelectomy can be used in adult males and boys when varicoceles cause chronic testicular pain or lead to impaired fertility.
Indications for varicocele surgery include:
Varicoceles that cause no symptoms typically do not need treatment.
Should I Worry If One Testicle Is Bigger?
Which Varicoceles Surgery Is Best?
In practice, certain types of varicocelectomy are preferred for the treatment of infertility, pain, or pediatrics:
Potential Risks of Varicocelectomy
As with all surgeries, varicocele surgery carries a risk of injury and complications, including:
Risk of RecurrenceStudies suggest that anywhere from 6% to 20% of males undergoing varicocele surgery will experience recurrence and require additional treatment. The reason for recurrence is often unknown.
Risk of Recurrence
Studies suggest that anywhere from 6% to 20% of males undergoing varicocele surgery will experience recurrence and require additional treatment. The reason for recurrence is often unknown.
How Microsurgery Is Used to Reverse Vasectomies
Varicocele surgery is generally safe, offering high levels of pain relief with relatively few side effects.
When used in men with infertility, varicocele surgery can triple the likelihood of conception from 13.9% to 32.9%.Even if the sperm count is not fully restored, varicocelectomy can greatly improve the effectiveness ofin vitro fertilization (IVF)and other forms of assisted fertility, so it is worthwhile.
How to Prepare for Varicocele Surgery
Varicocele surgery is typically performed underregionalorgeneral anesthesia. In both cases, you will need to stop eating and drinking beforehand to avoid vomiting and accidentalaspiration.
Among medications that need to be stopped before surgery:
What Happens if a Varicocele is Left Untreated?If left untreated, varicoceles can affect blood flow to the testicles wheretestosteroneis produced. Reduced testosterone levels can lead to lower sperm counts, poor sperm quality, and infertility.
What Happens if a Varicocele is Left Untreated?
If left untreated, varicoceles can affect blood flow to the testicles wheretestosteroneis produced. Reduced testosterone levels can lead to lower sperm counts, poor sperm quality, and infertility.
Risks of General Anesthesia You Should Know
What Happens During Varicocele Surgery?
Once you are prepped for surgery, you are wheeled into the operating room and placed in a supine (upward-facing) position on the operating table. The surgical team typically consists of a urologist, anesthesiologist, and surgical nurse.
Depending on the type of procedure you are undergoing, you may be givenlocal, regional, or general anesthesia.
Microscopic Varicocelectomy
Microscopic varicocelectomy is performed either with regional or general anesthesia. The surgery takes between one to three hours depending on whether one or both sides are being treated.
Laparoscopic Varicocelectomy
Laparoscopic varicocelectomy is also performed either with regional or general anesthesia. The timeline is shorter, lasting 30 to 60 minutes depending on whether one or both sides are being treated.
For laparoscopic varicocelectomy, three “keyhole” incisions of 1.5 centimeters (roughly 1/2 inch) are made in the lower abdomen. One incision accommodates the viewing scope (called the laparoscope), while the others accommodate specialized surgical tools.
Prior to ligation, the abdomen is slightly inflated to better expose the surgical site. The enlarged vein is then lifted and ligated with clamps or sutures.
Percutaneous Embolization
Percutaneous embolization is usually performed with local anesthesia. It generally takes an hour to complete but may take longer if both testicles are treated.
Once positioned, the varicoceles are either sclerosed (scarred) with a chemical or occluded (blocked) with electricity. Once the blood flow has been diverted, the catheter is removed and the tiny incision is sealed with adhesive strips.
Recovery From Varicocele Surgery
Recovery can take anywhere from one to two days for percutaneous embolization, two to four weeks for laparoscopic surgery, and three to six weeks for open surgery.
After surgery, your scrotum and groin may be bruised and swollen, and you may experience lingering pain for up to six weeks. Even so, most symptoms resolve relatively quickly, with some people returning to work in two to three days.
To promote healing and get back to normal life sooner:
How to Care for a Surgical Wound
Your healthcare provider will schedule follow-up visits to see how well you are healing. If the aim of surgery was to restore fertility, your provider will wait three to six months before performing a sperm analysis.
This is because spermatogenesis (the development of new sperm cells) takes roughly 72 days. Testing earlier may lead to false results.
When to See a Healthcare Provider
While uncommon, infections can occur after varicoceles surgery, especially if you don’t followwound care instructions.
Call your healthcare provider immediately if you experience:
Summary
Varicocelectomy is a surgical procedure used to correct varicoceles. It is typically used when varicoceles cause infertility or chronic testicular pain. It can also be used in boys to prevent infertility in later life.
Varicocelectomy can be performed as open or laparoscopic surgery or with percutaneous embolization. Recovery can take anywhere from a day or two with percutaneous embolization or up to six weeks with open surgery. Side effects include testicular numbness or swelling and varicoceles recurrence.
9 Sources
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