A varicocele is a complex of enlarged veins that lie just above the testis, a bit like a varicose vein in the leg. They can sometimes cause discomfort, but may not cause any symptoms at all.
They can lead to a raised temperature of the testis which may affect sperm production and quality.
Varicoceles can be repaired through either an operation to tie off the small veins, or with an x-ray procedure to inject small coils into the veins so that they shrivel up (embolisation). They are treated either for pain, or in an effort to improve the sperm count and/or quality.
Varicocele procedures
Microscopic Varicocele Ligation
Using a microscope to do the procedure offers the best results in many of the reported studies. A small cut in the groin is made under a general anaesthetic.
The microscope is used to both preserve important blood vessels going to the testis whilst tying off all the veins that are causing the problem. This procedure can be performed as a day case.
Embolisation
Embolisation is a treatment done under local anaesthetic with tiny coils that are put into the swollen veins around the testis so that they shrivel up. The veins are accessed through larger veins usually starting in the neck or groin. A specialised doctor, called a radiologist, performs the procedure using x-rays to guide the position of the coils.
Laparoscopic varicocele ligation
Laparoscopic varicocele ligation is another alternative treatment that involves clipping the veins where they enter into the abdomen. Under a general anaesthetic, small holes are made in the abdomen and a camera and instruments are placed through these to clip the veins that are causing the varicocele.
Microscopic Varicocele Ligation
A small cut is made in the groin area through which the procedure is carried out. It takes up to an hour under a general anaesthetic. The procedure is performed as a day case. There are dissolvable stitches in the skin. There will be some discomfort in the groin area after and pain killers are prescribed to control this. You may see some bruising around the incision or in the scrotum. This will resolve with time. However, if there is also a lot of swelling with this, please contact us so we can organise a review.
There is normally a four-week recovery time, where any exertional activity, such as heavy lifting should be avoided. Light work can be resumed prior to this; a week off work is recommended.
Contact Information
For any queries or information regarding prices, please contact Jo Smith on 0161 495 7791 or email n.fuller@manchesterurology.org.uk
Links
Information on open/microscopic varicocoele surgery through the British Association of Urological Surgeons can be found here:
ttp://www.baus.org.uk/_userfiles/pages/files/Patients/Leaflets/Varicocele_open.pdf
Information on varicocoele embolisation through the British Association of Urological Surgeons can be found here:
ttp://www.baus.org.uk/_userfiles/pages/files/Patients/Leaflets/Varicocele_embolisation.pdf
Information on laparoscopic varicocoele surgery through the British Association of Urological Surgeons can be found here:
http://www.baus.org.uk/_userfiles/pages/files/Patients/Leaflets/Varicocele_lap.pdf