A varicocelectomy is a surgical procedure done to manage enlarged veins around the testes, also called varicoceles, in the scrotum. Varicoceles are quite common, might not be noticed at all throughout your life and are rarely dangerous.
What is a varicocele
The scrotum is a sac of skin that hangs just below the penis and it contains the testicles which produce and store sperm and also produce certain hormones like testosterone. The scrotum hangs outside the body so that a lower temperature could be maintained for the sperm production. The scrotum also contains arteries and veins that deliver blood to the reproductive glands. A varicocele is similar to varicose veins in the leg. The veins have one-way valves that move blood from the testicles to the scrotum and then back to the heart. However, sometimes the one-way valve in the vein, which is supposed to ensure that the blood only flows to the heart, doesn’t work very well and the blood begins collecting in the vein, enlarging the vein and producing varicocele. Why varicoceles form is not certain and so there are no known preventive measures. Varicoceles most often occur in the left testicle and it could shrink your testicle.
Symptoms
Varicoceles could cause three issues which are decreased fertility, decreased production of testosterone in the testes, or slight discomfort or pain. (1) Varicoceles often have no symptoms or complications. Sometimes there may be a dull, recurrent pain and or swelling or a lump in the scrotum. The pain might be reported when they are standing for longer periods of time and might subside when they are lying down on their backs. Sometimes, the enlarged veins might be visible and look like a bag of worms. Sperm production and sperm quality might be decreased, and testosterone levels might be decreased leading to decreased fertility. In rare instances, the presence of a varicocele could cause there to be no sperm at all in the ejaculate. Rarely, varicoceles could also decrease testosterone levels so low that it could cause other complications like decreased libido etc. A varicocele will not get better on its own and it can happen at any age.
Diagnosis
The doctor may diagnose a varicocele by various methods. The doctor could do a physical exam to feel for the presence of varicoceles, could ask for a semen analysis and a blood test to test your fertility levels and could also do a scrotal ultrasound to measure how big the veins have become. There are 4 different sizes or grades of varicoceles. Grade 0 can only be seen by ultrasound, Grade I can only be felt when you are doing a Valsalva maneuver, Grade II can be felt but not seen and Grade III can be felt and seen. A Valsalva maneuver is done with the person closing their mouth and nose and trying to push the air out or bearing down. If the varicocele is not bothering you or affecting your fertility, you might not need any treatment.
If the varicocele is causing minor pain or discomfort, it could be treated with painkillers or wearing supportive underwear. If the varicoceles are causing too much pain, causing infertility or shrinking your testicles, you might have to undergo a varicocelectomy. Also, if the varicocele is damaging your testicle, it might need to be treated.
What is varicocelectomy
In this surgical procedure, the affected vein is cut and sealed so that the blood will not flow into this vein and diverted through to other healthy veins. The procedure can be done as an open surgical procedure, Laparoscopic procedure with the use of a scope and a Microsurgical procedure by performing the procedure under an operative microscope. The best way is to do a microsurgical procedure as the magnification helps in identifying the enlarged veins in a much precise manner and ligating them properly. At Xenith the method used is the Microsurgical Varicocelectomy done under a high end operating microscope thus giving the best outcomes for this procedure. . You can usually go home a few hours after the surgery or when the doctors deem you are well enough to go home. You might have some swelling and some pain in the scrotal area and might need to take pain killers and apply an ice pack. You also will have to avoid strenuous exercise, lift heavy objects, or sex for the first one or two weeks after surgery. Contact your doctor right away if you have heavy bleeding at the site, increased pain or fever. A varicocelectomy is a relatively safe procedure, it can improve your fertility and decrease any testicular pain. The testosterone levels could also increase after a varicocelectomy.
In a very few people, the varicocele could reoccur after treatment or one might still have some pain or discomfort.
Not all varicoceles need to be or should be operated. It is important to identify and decide when to operate and when not to intervene. So speak to your doctor about what is best for you if you are suffering from varicoceles. If you are having any of the symptoms of a varicocele and are concerned about how it might affect your fertility, please feel free to contact the experts at Xenith Advanced Fertility Centre.