This is a surgical procedure where testicular veins are ligated so as to avoid venous reflux of blood to the testicle, and the harmful consequences of this for fertility.
Surgical repair of varicocele is not required for all patients. There are specific indications which are as follows:
- Pathological levels found with a spermiogram
- Progressive testicular atrophy during puberty
- Testicular pain not attributable to other causes
It is essential that there is a recent spermiogram for reference.
Occasionally the sperm may need to be frozen and cryogenically stored prior to the procedure.
On admission to the hospital a pre-operative assessment is carried out which includes:
- Blood tests
- Chest X-ray
- Cardiac assessment
In the event that a patient is on anticoagulant medication it is necessary for this to be discontinued, or replaced with an alternative, a few days prior to the surgery.
How the repair of the varicocele is performed
The procedure is usually performed under general anesthesia, through a small incision made into the groin.
Following this, the spermatic veins are located and ligated.
The procedure may be performed with the assistance of a microscope and this is known as microsurgical varicocele repair.
This technique offers the surgeon better imaging, with fewer complications and a more rapid patient recovery.
After the procedure
At discharge you will receive instructions on
- Resuming any anticoagulant (blood-thinning) medication you may have been taking prior to the procedure
- How long to avoid lifting heavy weights or doing strenuous exercise
- Antibiotic medication you need to take at home
- When to repeat the spermiogram
Most patients do not have any notable problems after the procedure and are discharged from hospital one or two days after surgery.