Varicocele surgery

A swollen or dilated vein in the scrotum is called a varicocele. Most normal veins in the scrotum are constricted and not dilated. A large varicocele vein is more often found in the left scrotum rather than in the right side. A varicocele found in the right-side of the scrotum should be carefully examined because it may be an indicator of cancer in the right kidney. These veins are present in about 20 to 25% of men and are usually considered harmless. However, this condition is the cause of about 40% of male infertility. Varicoceles are easy to find and the remedy for infertility caused by them is varicocele surgery.

Varicocele surgery consists of three types. All three types of varicocele surgery will results in surgical litigation of the vein. This means that the blood supply to the vein is severed and then restricted by suturing it so that it is tied off and closed or by stapling it closed.

Varicocelectomy (Conventional Open Surgery)
A Varicocelectomy is the most common surgery for this condition. This is also called conventional open surgery. It is a surgery that is done on an outpatient basis. It is performed under general anesthesia or under spinal anesthesia. The doctor makes a 2 to 3 inch incision in the groin area, locates the varicocele and ties it off. Sometimes the surgeon will make the incision in the lower abdomen instead of the groin area. This is because there are fewer blood vessels in the abdomen they are larger and easier to identify. The problem with making the incision in groin area is that the lateral drainage veins may be missed and the surgery will not be as successful. Men who undergo this type of Varicocele surgery should avoid strenuous activity for several days after surgery. The patient is usually allowed to go back to work about three or four days later.

A common complication associated with this type of surgery is fluid around the testicle also known as hydrocele and risk of infection. There is also a 20% chance that the varicocele will grow back if the smaller drainage veins are missed. The testicular artery may also be inadvertently damaged which will result in a lack of blood supply to the testicles, causing them to shrivel.

Micro surgical litigation is another type of varicocele surgery in which a smaller incision is made through the skin and fatty tissue rather than through the muscles. This results in less pain and faster recovery for the individual. An operating microscope is inserted and is used for the doctor to locate the varicoceles. With this type of surgery the large varicoceles are severed and then stapled closed. The smaller ones are cut and then sutured closed. This operation takes less than an hour and is done on an outpatient basis. If varicoceles are found on both sides the surgery can take up to an hour and half. The use of the microscope in this type of varicocele surgery is better at identifying the main testicular artery so it can be avoided. Microsurgery has a higher success rate and fewer complications associated with it. It also leaves a smaller scar and less recovery time.

The Laparoscopy varicocele surgery is done very much like the conventional open surgery. The incision is typically made through the abdomen rather than the scrotum however. A larger incision may be made than the varicoceclectomy and the veins will be pulled out of the body to be severed and tied off. This type of varicoceles surgery results in significantly more postoperative pain and chances are higher for infection than they are with microsurgery. There is also a higher incidence of hydroceles following this type is surgery. The chances for arterial injury are higher as well. The recovery time is also longer than it is with microsurgery.

Last updated on Jan 5th, 2010 and filed under Medical Treatment. Both comments and pings are currently closed.

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