A varicocelectomy is a surgical procedure that is performed in which a varicocele is removed. Varicoceles are veins which are located in the testicles. The vein is similar to a varicose vein found in the legs. Many times, varicoceles occur on the left portions of the scrotum and typically appear after puberty. A varicocele will not just go away; a varicocelectomy is required in many cases in order to correct the condition.
How is a Varicocelectomy Performed?
The varicocelectomy is a microsurgical procedure that will last approximately an hour and a half. A small incision is made in the groin through which the veins in the testicle can be accessed. A specially designed microscope is used to locate the abnormal veins which are then dissected away and tied to prevent the flow of blood in the general area. This will not inhibit the flow of blood to healthy veins. The varicocelectomy is generally successful in ensuring that the abnormal veins are tied off without shutting off all the flow of blood to and from the testicle. Using a microsurgical procedure allows surgeons to tie off the abnormal vein while preserving the lymph vessels and testicular arteries. This helps reduce the chances of recurrence or complications.
Are there Risks and Benefits to the Procedure?
The primary risk associated with a varicocelectomy comes from exposure to the general anesthetic. This along with bleeding and the chance of infection are common risks associated with any type of surgical procedures. There is a very small risk that the testicular artery could be damaged or that a hydrocele formation could occur. The chances of either of these are less than one percent. There is also a less than five percent chance that the varicocele will recur.
The benefit of a varicocelectomy is that it will typically improve male fertility as well as relieve discomfort and pain. After the surgery, about 70 percent will see improvement in a semen analysis within 6 to 9 months. More than half of the males typically report that their partner became pregnant within a year to 18 months following the procedure.
What are the Symptoms Associated with Varicoceles?
Many times, there are no apparent symptoms but varicoceles are discovered by a primary care physician during a routine physical. Some individuals with varicoceles have associated pain which can range from being very dull and uncomfortable to very sharp pains. Pain that is associated with varicoceles can increase during standing, sitting upright or during strenuous activities. It will usually go away once the individual lies flat on his back. Sometimes, the testicle (usually the left side) which has the varicocele may appear noticeably smaller than the other one. This can be because the limited blood flow inhibits its growth. There can be reduced sperm flow and the scrotum can appear to be swollen.
What to Expect After the Procedure
It is very common for there to be bruising and swelling following a varicocelectomy. Oozing at the site of the wound is also very common. Each individual bruises differently but it is not uncommon for the bruising to extend onto the shaft of the penis. Swelling is also very common with the procedure. As a general rule, as long as the wrinkles in the scrotum are visible the swelling is at a reasonable level. If it is suspected that there is unusual swelling it is always best to contact the surgeon. Most of the time, the individual will only have to be off work for a couple of days depending on the type of work they do. It is important to consult with the surgeon about when it is acceptable to return to work and a post-operative exam should be scheduled for about a week after the surgery is done.