What is varicocele surgery?
Varicocele surgery is a medical procedure used to treat varicoceles, which are enlarged veins in the scrotum that may cause discomfort, swelling, or fertility problems. These veins are similar to varicose veins in the legs and can interfere with normal blood flow. The purpose of the surgery is to seal off these enlarged veins, allowing blood to flow through healthier ones. This helps relieve pain, improve circulation, and potentially enhance fertility by creating a healthier environment for sperm production.
Benefits of varicocele surgery
After undergoing varicocele surgery, many patients report reduced testicular pain and discomfort. The removal or sealing of the enlarged veins often leads to better blood flow in the scrotum, which supports testicular function. In men experiencing fertility issues, surgery may help improve sperm production and quality, increasing the chances of natural conception.
Alternative treatments
In addition to surgery, there is a non-surgical treatment option known as varicocele embolisation. This minimally invasive procedure involves inserting a small catheter through a vein and using it to block the problematic veins from the inside. Embolisation doesn’t require significant surgical cuts, which means patients typically experience less discomfort and a faster recovery time. This approach is permanent and offers results that are similar to surgery in terms of relieving pain and improving sperm parameters. Because it carries a lower risk of complications and requires less downtime, embolisation is often a good alternative for those who want to avoid traditional surgery.
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Ways to payBefore surgery
Initial consultation
Diagnosing a varicocele usually begins with a physical exam performed by a urologist. The doctor will examine the scrotum while you are both standing and lying down to check for any swollen veins. You may be asked to perform the Valsalva manoeuvre, which involves bearing down as if trying to have a bowel movement while holding your breath. This can help make the varicocele more noticeable. To confirm the diagnosis and better understand the size and location of the varicocele, an ultrasound is commonly used for this purpose. This imaging test provides detailed pictures of the veins in the scrotum. In cases involving fertility concerns, your doctor may also order a semen analysis to evaluate sperm count and quality.
Pre-surgery preparations
Before surgery, your urologist will provide you with specific preoperative instructions. You will likely be advised to avoid eating solid foods for several hours leading up to surgery. Fasting helps reduce the risk of complications during anaesthesia. Clear liquids may be allowed up to a specific time before the procedure to keep you hydrated. Your doctor may also ask you to temporarily stop or adjust medications that could interfere with anaesthesia or healing. Following these instructions carefully is crucial for your safety and the successful outcome of the surgery.
During surgery
Varicocele surgery is usually an outpatient procedure, which means you’ll go home the same day. It’s typically performed under general anaesthesia, so you’ll be asleep and won’t feel any pain during the operation. Depending on the technique used, the surgeon may make small incisions in the lower abdomen or scrotum. Through these incisions, special instruments are used to identify and seal off the affected veins, rerouting blood flow through healthier ones. In some cases, imaging with contrast dye may be used to guide the procedure and ensure accuracy. Afterwards, the incisions are closed using dissolvable stitches, which do not require removal later.
Types of varicocele surgery
There are two main types of varicocele surgery. The first is microscopic varicocelectomy, which involves making a small incision and using a high-powered microscope to carefully locate and repair the problematic veins. This technique allows for high precision, helps preserve healthy tissue, and typically results in a shorter recovery time. The second is laparoscopic varicocelectomy, which utilises tiny incisions in the abdomen and a small camera to enable the surgeon to see and treat the veins. This approach is less invasive than traditional open surgery and usually takes less time to perform, with faster healing afterwards. Both methods aim to correct the varicocele by blocking the faulty veins and restoring normal blood flow.
After surgery
Immediate recovery
Once the procedure is complete, you’ll be taken to a recovery area where medical staff will monitor you as you wake up from anaesthesia. You may feel some pain or soreness in the groin or lower abdomen, but this is usually mild and can be managed with medication prescribed by your doctor. You’ll go home the same day, with clear instructions on how to care for the incision site, manage pain, and gradually return to normal activities. Gentle movement, such as walking, is encouraged soon after surgery to improve circulation and reduce the risk of blood clots. In some cases, small drainage tubes may be used temporarily to remove excess fluid; however, these are typically removed quickly and with minimal discomfort. Most patients can return to light activities within one to two days, although they should avoid strenuous physical exertion for a while to promote proper healing.
Long-term recovery
Full recovery from varicocele surgery typically takes between three and six weeks, depending on the technique used and your overall health. During this time, you will be advised to avoid intense exercise, sports, and sexual activity until cleared by your doctor. Regular follow-up appointments are essential to ensure that healing is progressing well and to address any concerns that may arise. These check-ups help ensure that the veins remain sealed and prevent the development of new complications.
Risks and complications
As with any surgical procedure, varicocele surgery does carry some risks. These may include infection, bleeding, fluid buildup, or recurrence of the varicocele. Although such complications are relatively rare, they underscore the importance of selecting an experienced surgeon and adhering closely to all medical advice. Overall, varicocele surgery is considered safe and effective, with a strong track record of improving symptoms and fertility in many patients.
Impact on fertility
For men who are dealing with infertility, varicocele surgery can offer meaningful improvements. By restoring normal blood flow and reducing pressure on the testicle, the procedure often helps the testicle return to a more normal size and function. Studies show that sperm count and movement improve in about 60 to 80% of men after surgery. Pregnancy rates among couples after surgery range from 30 to 50%, depending on the severity of the condition and other health factors. Surgery may also help restore normal testosterone levels, which can benefit overall energy, mood, and reproductive health.
Appointment and Treatment Plan
Initial Consultation
You’ll meet with a urologist to discuss symptoms like pain or fertility issues. A physical examination and ultrasound will confirm the presence of a varicocele. Your doctor will explain whether surgery is necessary and review your treatment options with you.
Pre-Surgery Preparation
Before surgery, you’ll be asked to fast for a specific period and may need to stop certain medications. A quick health check ensures you’re ready for the procedure. You’ll also need to arrange a ride home, as you won’t be able to drive afterwards.
Day of Surgery
The procedure is typically performed under general anaesthesia and lasts 30 to 60 minutes. A small incision is made in the groin or lower abdomen to seal the enlarged veins. Dissolvable stitches are used, and you’ll be monitored as you wake up.
Right After Surgery
Some mild pain, swelling, or bruising is normal. You’ll get instructions on pain relief and caring for the incision. Most patients are discharged the same day and are advised to wear supportive underwear for added comfort and support.
Recovery at Home
Rest for a few days and avoid heavy lifting or strenuous activity. Most people can return to regular routines within one to two weeks. Supportive underwear can help reduce swelling during this time.
Follow-Up Appointment
A follow-up visit is usually scheduled within one to two weeks. Your doctor will assess your healing, address any questions you may have, and monitor your progress to ensure optimal recovery. Further tests may be planned if fertility is a concern.
Long-Term Outlook
Most patients recover fully, experiencing relief from symptoms and an improvement in fertility. Complications are rare, and recurrence is uncommon. Benefits such as improved sperm quality or testosterone levels may become apparent within a few months.
Experts
We are proud to provide patients with access to a wide range of clinicians, chosen specifically for their knowledge and reputation in their area of expertise. Our experts align with our values: putting you at the centre of your care and educating you on your options at each step of the journey. We encourage you to learn more about our clinicians and how they can help you below. As always, please contact our patient services team if you require any additional information.
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FAQs
A varicocele is an enlargement of the veins within the scrotum, which may lead to discomfort and potentially impact fertility. It is essential to address this condition if symptoms arise.
A varicocele is typically diagnosed through a physical examination, followed by ultrasound imaging to confirm its presence and severity. This combined approach ensures accurate identification and assessment of the condition.
Varicocele embolisation is an effective non-surgical alternative to varicocele surgery, as it involves blocking the affected veins and typically results in a shorter recovery time. This option can provide similar outcomes to traditional surgical methods.
The recovery time after varicocele surgery generally allows patients to resume light activities within one to two days, while full recovery usually takes 3 to 6 weeks, depending on the surgical technique employed.
Yes, varicocele surgery can enhance fertility by improving sperm quality and testosterone levels, thereby increasing the likelihood of natural conception.
Varicocele surgery is generally considered a standard and safe procedure rather than a major surgery. It is typically performed on an outpatient basis, meaning patients can go home the same day. The surgery involves small incisions and the use of specialised surgical tools to seal or remove the enlarged veins around the testicle. Because it is usually done under general anaesthesia, patients do not feel pain during the operation. Recovery time is relatively short compared to more invasive surgeries, with most patients experiencing only mild discomfort and returning to normal activities within a few weeks.
Most patients report only mild pain or discomfort following varicocele surgery. This mild pain can usually be managed effectively with simple painkillers or prescribed pain medications. Some swelling or bruising around the surgical site is common but typically resolves within a few days. Using ice packs and wearing supportive underwear can help reduce discomfort during the recovery period. While pain levels vary from person to person, severe or prolonged pain is rare. Your urologist will provide you with detailed instructions on how to manage any pain and when to seek medical advice if the pain worsens.
If left untreated, a varicocele may continue to cause symptoms such as testicular pain or discomfort, which can worsen over time. In some cases, untreated varicoceles can negatively affect sperm quality and testosterone production, potentially leading to fertility issues. The enlarged veins around the testicle can cause increased temperature and reduced blood flow, which may impair testicular function. However, many varicoceles are asymptomatic and do not require treatment. It is essential to consult a healthcare provider to assess the severity and determine whether intervention is necessary, taking into account symptoms and fertility considerations.
Varicocele surgery is often considered worth it for men experiencing symptoms such as testicular pain or fertility problems. The procedure can significantly improve blood flow by blocking blood flow through the affected veins and redirecting it through healthy veins. This can lead to reduced pain, improved semen quality, increased sperm count, and better testosterone production. Many patients report an enhanced quality of life and an increased chance of natural conception after surgery. While no surgery is without risks, varicocele repair is generally a safe procedure with a high success rate, making it a valuable treatment option for those affected.
After surgery, making a few lifestyle changes can support your recovery and help you feel more comfortable. Wearing snug, supportive underwear, such as a jockstrap, can help reduce pressure and discomfort in the surgical area. It’s also important to avoid lifting heavy objects or doing intense physical activity for several weeks. Gentle exercises, such as walking or swimming, can promote healthy blood flow and help accelerate healing. Eating a well-balanced diet rich in fibre, vitamins, and minerals can support your body’s recovery. Staying hydrated and getting plenty of rest are also key. These habits not only aid in immediate healing but also contribute to improved long-term health and well-being.