Varicocele surgery
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Varicocele Microchapters |
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Varicocele surgery On the Web |
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American Roentgen Ray Society Images of Varicocele surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Surgery
Varicoceles may be managed with a scrotal support (e.g. jockstrap, briefs). However, if pain continues or if infertility or testicular atrophy results, the varicocele may need to be surgically ligated (tied off).A vasotonic drug is preferred in addition to the scrotal support.
Varicocelectomy, the surgical correction of a varicocele, is performed on an outpatient basis. The three most common approaches are inguinal (groin), retroperitoneal (abdominal), and infrainguinal/subinguinal (below the groin). Various other techniques may be used. Ice packs should be kept to the area for the first 24 hours after surgery to reduce swelling. The patient may be advised to wear a scrotal support for some time after surgery.
Possible complications of this procedure include hematoma (bleeding into tissues), infection, or injury to the scrotal tissue or structures. In addition, injury to the artery that supplies the testicle may occur.
An alternative to surgery is embolisation, a non-invasive treatment for varicocele that is performed by an interventional radiologist. This involves passing a small wire through a peripheral vein and into the abdominal veins that drain the testes. Through a small flexible catheter, this doctor can obstruct the veins so that the increased pressures from the abdomen are no longer transmitted to the testicles. The testicles then drain through a bunch of smaller, collateral veins. The recovery period is significantly less than with surgery and the risk of complications is minimised. However, overall effectiveness is not as high as surgery, which is still an option.