Varicocelectomy

What is Varicocelectomy?

Varicocelectomy is a surgical procedure performed on males to treat a condition called varicocele. Veins in the scrotum may sometimes get enlarged and swollen. It leads to poor blood flow to the testicles as blood starts pooling in the veins. This may lead to infertility due to low sperm production and decreased sperm quality. There is no medication to treat the said condition, and therefore surgery is often the only option. Varicocelectomy is aimed at restoring proper blood flow to the testicles by surgically treating the swollen blood vessels.

 Who's a Good Candidate for Varicocelectomy?

Most of the time, varicoceles do not cause any symptoms except for enlarged veins. In such a case, doctors do not recommend surgery to avoid any risks and complications related to the surgical procedure. However, patients who feel persistent pain in the scrotum and/or infertility may be recommended varicocele surgery or Varicocelectomy.

Additional symptoms may arise due to varicoceles like decreased testosterone leading to decreased sex drive or weight gain. In such a case also, doctors may recommend Varicocelectomy. In general, varicoceles develop on the left side of the scrotum in the teenage years. They may grow with age. Varicoceles that may develop on the right side of the scrotum may sometimes be a sign of a tumour. If that is the case, doctors will recommend surgery. Therefore, any grown healthy male who suffers from disruptive symptoms due to varicoceles is a good candidate for Varicocelectomy.

How is the Varicocelectomy Procedure Performed?

A varicocelectomy surgery entails cutting the enlarged veins in the scrotum and then closing off the ends. This procedure can be done via laparoscopic surgery or a microsurgical varicocelectomy.

• Laparoscopic Varicocelectomy:  This procedure may take half an hour to 45 minutes. A laparoscopic tube is inserted through the patient's abdomen, and surgery is performed. This procedure is opted for when there are fewer veins to close off.
• Microsurgical Varicocelectomy: One centimetre-long incision is made through the scrotum, and a microscope is used to identify the veins that need to be cut and closed off. In this procedure, the testicular cord is delivered downward with continuous double traction away from the external ring. This procedure may take up to 3 hours.

It is mostly an outpatient procedure, and patients can usually go home the same day. Here are the following important details to know regarding the procedure:

Before the surgery:

1. Routine tests are done a few days prior to the procedure.
2. Patients will be given general or spinal anaesthesia. Patients may be asked to fast at least 8-10 hours before the surgery if they are undergoing general anaesthesia.

During the surgery:

1. The patient will be given anaesthesia intravenously or through spinal injection. The forgery may take 30 minutes to 3 hours, depending on the type of Varicocelectomy being performed.

Post-surgery:

The patient will be shifted to a recovery room and observed for 1-2 hours.

Recovering from Varicocelectomy Surgery

Most of the recovery happens at home since patients are discharged the same day. Patients may be advised to avoid sex for a few weeks, lifting heavy things, contact with water, and putting extra strain while urinating. Patients will be prescribed pain medication and may also keep ice packs to help with the swelling and pain. Complete recovery usually happens in about two weeks.

Following recovery, patients may get their sperm count checked to see any improvement in sperm production post-surgery.

During the recovery period, patients may keep an eye out for any varicocele surgery side effects.

Possible Side Effects of Varicocele Surgery

All surgical procedures may have side effects and carry the risk of complications. Like any surgical procedure, there may be some side effects. Side effects of a varicocelectomy procedure may include the following:

1.  Bleeding at the site of the incision.
2. Clots
3. Prolonged pain
4. Post-surgery infection
5. Shrinking of testicles (atrophy)
6. Hydrocele
7. Difficulty in Urinating
8. Swollen and Painful Legs
9. Nausea

Any prolonged or intense symptoms from the above after the surgery must be immediately consulted with the doctor.