Varicocele Treatment

Varicocele Treatment

Most males with a varicocele have no symptoms. But varicoceles are a concern for many reasons. Some may cause infertility (problems fathering a child) and slow growth of the left testicle during puberty. Varicoceles may be the cause of fertility problems in about 40% of men who have problems fathering a child. sometimes they can cause a swelling in your scrotum or even cause a dull pain mainly on standing or lifting heavy weight.

A varicocele is when veins called the pampiniform plexus become enlarged inside your scrotum (surrounding your testicles). About 15% of males have a varicocele.

Causes

usually defective valves in the main vein that drains your testicles to the main vena-cava that takes the blood back to the heart. Its more often found on the left side due to anatomical reasons. sometimes varicoceles can result from other causes like cancer of the kidney.

Diagnosis

Varicoceles are found through self-exam of the scrotum or during a routine doctor's exam. They've been described as a "bag of worms" because of how they look and feel. Urologists often check for varicoceles with the patient standing and sometimes they confirm the presence and significance of the varicocele through an ultrasound and doppler examination.

Treatment

Often, varicoceles are not treated unless they are causing problems. Treatment is offered for males who have:

fertility problems (problems fathering a child) or the left testicle growing more slowly than the right
or its causing pain.

There are no drugs to treat or prevent varicoceles.

Surgical treatment

There are many ways to do varicocele surgery. All involve blocking the blood flow in the pampiniform plexus veins.

Open Microscopic

Open surgery repair is done through a single 1 inch cut. The surgeon may use a magnifying glass or operating microscope to see small veins. The surgery can be done under local or general anesthesia.

Laparoscopic Surgery

Laparoscopic surgery is done through thin tubes put into your body through a small cut. The surgeon uses a special camera to see inside your body. Laparoscopic surgery is done under general anesthesia.

Surgery Results

Since surgeons have started using smaller cuts through the muscle for open surgery, healing time and pain are about the same with open and laparoscopic surgery. Problems after either surgery are rare. Problems include:

  • - Varicocele remaining (persistence) or coming back (recurrence)
  • - Fluid forming around the testicle (hydrocele)
  • - Injury to the testicular artery

There is a small chance surgery won't correct the problem. In rare cases, injury to the testicular artery can lead to loss of the testicle. Persistence or recurrence of the varicocele happens in fewer than 1 of 10 patients who have surgery. Open surgery done with magnification has a low persistence rate or chance of varicocele coming back.

Most of the time, patients return to normal activities after 5 days with little pain.

Percutaneous Embolization

Embolization is done by a radiologist. A special tube is put into a vein in either the groin or neck. An X-ray is used to check the enlarged pampiniform plexus veins. Then coils or balloons are opened through the tube to block the veins. This halts the blood flow in the pampiniform plexus veins and the varicocele shrinks. Percutaneous embolization is most often done with local anesthesia. Some problems are:

  • - Varicocele remaining (persistence) or coming back (recurrence)
  • - The coil moving from where it was placed

This method isn't used at most centers.

Healing after surgery is fast and pain is often mild. You should avoid exercise for 10 to 14 days. You can often return to work 7 days after surgery.

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