Overview
Varicoceles is a common urological problem that mostly occurs in adolescents and young men. The disease is benign and not life-threatening but, in some cases, may cause sexual dysfunctions and impact fertility in men.
A varicocele is a dilated vein or varicose vein of the testicle. It mostly affects the left testicle but can occur in both testicles. It occurs when the veins that deliver blood in the testicles develop faulty valves. Blood pools inside the veins causing engorgement and dilated veins.
Varicoceles are most of the time asymptomatic (do not have any symptoms) and people may not need any treatment. Sometimes, male patients are accidentally diagnosed with varicoceles while undergoing treatment for infertility or delayed pregnancy in their partners. Around 40% of men who have infertility problems have been caused by varicoceles.
Treatment for varicoceles depends on the severity of the condition and the symptoms that may need medical attention.
Do I need surgery for varicocele?
Varicoceles may not need immediate surgery or even treatments. Some patients may report noticeable discomfort and scrotal pain. Anti-inflammatory medications, painkillers, and home management are recommended for treating varicocele symptoms.
Treatment and surgery for varicocele depends on:
- Varicocele symptoms
- Size of varicoceles. Sometimes patients may develop a large lump in the scrotum
- Low testosterone levels
- Poor semen analysis
- Fertility goals
A varicocele surgery or varicocelectomy repairs the varicocele and can improve testicular function and testosterone levels. Evidence shows that varicocelectomy can help in treating male infertility that has been caused by varicoceles and improves the chances of pregnancy in their partners.
Varicocelectomy can also reduce testicular pain and treat testicular atrophy (shrinkage) of the affected testicle.
A varicocelectomy is done under general anesthesia. The surgeon uses a sterile scalpel to make small incisions to access the varicoceles. The damaged veins are then cut and sealed off. Sealing the damaged veins allows the blood to flow to other healthy veins.
Varicocelectomy can be microscopic or laparoscopic. A microscopic varicocelectomy is longer and takes 2-3 hours to perform compared to laparoscopic surgery which can be performed within 30 to 40 minutes.
An effective non-surgical treatment for patients who do not want to undergo a varicocele surgery is varicocele embolization. This procedure has a higher success rate and low risk of post-procedure complications.
A varicocele embolization is an outpatient procedure performed by an interventional radiologist. There is no incision or scar. A catheter of about 1/8 inch in diameter is used to perform the embolization under x-ray guidance.
Embolization blocks the diseased varicocele vein and diverts the blood flow to healthy veins. After successful diversion, the blood pressure decreases. It can provide immediate relief to pain.
What is varicocele surgery recovery time?
You can return to work within five days or a week after a laparoscopic varicocele surgery. Full recovery usually takes two to four weeks. Exercise can be resumed within two weeks. Recovery after an open varicocele surgery takes around three to six weeks.
Recovery after a varicocele embolization is faster. You can resume work within one to two days and start exercising within a week.
How do you recover after surgery?
After a varicocele surgery, you will feel some tenderness in the groin area. This may last for six weeks. Your doctor will prescribe pain medications and non-steroidal anti-inflammatory drugs (NSAIDs) for managing pain and inflammation. Take your antibiotics on time for proper healing and recovery.
Apply ice packs on the affected area for 10 minutes to reduce pain and swelling. Clean your hands before changing the bandages and keep your incision area clean and dry to avoid infections.
Add fruits, vegetables, and fiber-rich foods, and drink plenty of water for easy bowel movements. Constipation can put pressure on the incision site.
Abstain from sex and strenuous work and exercise until your doctor permits you.
Start walking slowly to allow blood circulation and avoid constipation.
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Don't just jump into a surgery because your doctor is advising you to go for it. Consult our doctors to know if you need a surgery at all. Rest assured, we WON'T recommend you surgery unless it's the last resort.
