Varicocele Treatment & Surgery
A varicocele is repaired with a surgical procedure called a varicocelectomy. Varicocele repair surgery is relatively simple. The goal is to locate the distended veins and tie them off or block them to prevent blood from pooling. Most commonly, surgery is performed through a single incision in the lower abdomen.
Preparation for Varicocele Procedure
No special preoperative tests are needed before a varicocele repair other than the standard lab tests required by some hospitals, ambulatory surgery facilities or anesthesiologists. For men more than 40 years old, an electrocardiogram (a test that checks for problems with the electrical activity of your heart) is usually required.
Varicocele Surgical Procedure
Varicocele repair may be performed with local, regional or general anesthesia, depending on the preference of surgeon and patient. General anesthesia is commonly used because it affords maximum patient comfort during the surgery.
Dr. Fisch uses small incisions, which avoids cutting as much muscle tissue and speeds recovery. Dr. Fisch has been perfecting surgical techniques for varicocele repair and has published articles on the topic such as “A Novel Surgical Approach to Subinguinal Varicocelectomy: Artery and Lymphatic Isolation Technique” that describe the improved procedures. Many urologists have adopted this technique.
In this varicocele repair procedure, a small incision is made in the inguinal area, in the region of the pubic hair, not in the testicles. The incision is about an inch in length. The abnormal blood vessels are closest to the skin at that area. The vessels are secured. The abnormal blood vessels are then microsurgically dissected away from the normal structures and tied off.
Recovery from Varicocelectomy Surgery
Varicocele surgery is usually done on an outpatient basis. Recovery is usually rapid and pain is usually mild. Swelling around incisions usually goes away after several days, and discoloration of the scrotum will generally resolve in a week or so. You shouldn’t lift anything heavy or exercise strenuously for two weeks, although office work can typically be done one to two days after surgery.
Complications from varicocele repair are rare, but can include a recurrence of the varicocele, formation of a fluid-filled space called a hydrocele, and injury to the testicular artery.