A surgical procedure performed for infertility and pain complaints, in which the dilated testicular veins inside the scrotum are ligated to regulate blood flow.
Indication
- Clinically palpable varicocele on physical examination associated with infertility
- Varicocele causing impairment in semen parameters (count, motility, morphology)
- Varicocele causing significant testicular volume reduction in adolescents
- Cases with persistent scrotal pain unresponsive to conservative measures
- Selected cases thought to contribute to low testosterone
Preparation
- No food or drink for 6-8 hours before the procedure
- Scrotal ultrasound and, if needed, semen analysis
- Blood tests and anesthesia evaluation
- Shaving of the surgical area is performed before the procedure
- Blood-thinning medications are adjusted according to the physician's recommendations
How it's performed
- General or regional anesthesia is administered
- The spermatic cord is reached through a small incision in the inguinal area
- Microsurgical (under microscope) technique is currently considered the gold standard
- The artery, lymphatics and vas deferens are preserved while the dilated veins are ligated individually
- The skin is closed with cosmetic sutures
- Same-day discharge is planned in most cases
Post-procedure
- Return to light activity within the first 24-48 hours
- Avoid heavy lifting and sexual intercourse for 1-2 weeks
- Scrotal support (appropriate underwear) may be recommended
- Repeat semen analysis at 3-6 months for infertility indications
- Follow-up examinations to monitor for recurrence and hydrocele
Risks
- Hydrocele formation (fluid collection around the testis)
- Varicocele recurrence
- Temporary pain or numbness in the inguinal area
- Wound infection (rare)
- Very rare testicular artery injury
FAQ
Does varicocele surgery improve sperm parameters?
Improvement in sperm count, motility and morphology may be seen in many patients; however, the pregnancy outcome depends on multiple factors and varies from individual to individual.
Why is microsurgery preferred?
Microsurgical technique is currently accepted as the gold standard because it preserves the artery and lymphatics, helping to keep recurrence and hydrocele rates lower.
Should every varicocele be operated?
No. Varicoceles that do not cause complaints and do not affect sperm parameters are most often managed with observation.
When can I return to work?
Return to desk-based work is generally possible in 3-7 days; those doing heavy work may return after about 2-3 weeks with their physician's approval.
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