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.
Illustration by Laura Porter for Verywell Health
Varicocelectomy is a common procedure with a relatively low risk of side effects and complications.
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.
Illustration by Laura Porter for Verywell Health
What Is a Varicocele?
Varicoceles often cause no symptoms but can causelow sperm countand decreased sperm quality, leading to infertility.
What Is Varicocele Surgery?
Varicocele surgery, also known as varicocelectomy, is typically performed as anoutpatient procedureand is minimally invasive.
Who Is a Good Candidate for Varicole Surgery?
Indications for varicocele surgery include:
Varicoceles that cause no symptoms typically do not need treatment.
Which Varicoceles Surgery Is Best?
The reason for recurrence is often unknown.
Does Varicocele Surgery Affect Fertility?
Varicocele surgery is generally safe, offering high levels of pain relief with relatively few side effects.
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.
Depending on the anesthesia used, you may need to stop eating at midnight the night before the procedure.
In the morning, you might take any medications your surgeon approves of with a sip of water.
Four hours before surgery, nothing should be taken by mouth, including gum or ice chips.
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 During Varicocele Surgery?
The surgical team typically consists of a urologist, anesthesiologist, and surgical nurse.
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.
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.
This is because spermatogenesis (the development of new sperm cells) takes roughly 72 days.
Testing earlier may lead to false results.
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.
Side effects include testicular numbness or swelling and varicoceles recurrence.
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