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Treating Varicocele

In most cases, varicocele is not serious. Your doctor may wait and watch the problem for a while. If needed, surgery or another procedure to close off the enlarged veins can be done. This may be suggested if you have pain, if the veins become unsightly, or if you and your partner are having trouble conceiving a baby.

Cutaway view of veins
Before surgery, the veins around the testicle are enlarged. This is from blood collecting in the veins.

Cutaway view of veins
After surgery, the enlarged veins are tied off. Veins deeper in the scrotum then carry blood away from the testicles.

Surgery: Open Varicocelectomy

Your doctor may recommend surgery to tie off the enlarged veins around the testicles.

  • You are given anesthesia to keep you comfortable. You may or may not be asleep.

  • An incision is made in the groin or in the lower abdomen.

  • The veins are then cut and tied off.

  • The incision is closed with sutures, staples, or surgical tape.

Surgery: Laparoscopic Varicocelectomy

Instead of open surgery, laparoscopic surgery may be recommended. This is surgery done through small incisions with an instrument called a laparoscope (a thin, telescope-like device).

  • You are given general anesthesia to make you “sleep” during the procedure.

  • Several small openings are made in the lower abdomen. The laparoscope is inserted through one opening. Surgical instruments are inserted through the other small openings.

  • The laparoscope sends magnified pictures to a video monitor. Using these pictures, the surgeon identifies the veins that need treatment.

  • The veins are clamped to seal them off.

  • The instruments are removed. The incisions are closed with sutures, staples, or surgical tape.

Percutaneous Occlusion

In place of surgery, your doctor might recommend sealing off the enlarged veins using percutaneous occlusion. A radiologic procedure called a venogram is used to create a map of the veins. A tube is then placed in the large vein in the groin. Materials are injected through this tube into the enlarged veins to block them off.

After Your Varicocele Procedure

  • You may feel some pain in your testicle for a few days.

  • Mild swelling around the testicle is normal after the procedure. Put an ice pack (or bag of frozen peas or rice) wrapped in a thin towel on the area to help. Do this for no longer than 20 minutes at a time.

  • Plan to rest for 2–3 days.

Call Your Doctor if You Have:

  • Ongoing pain not relieved by pain medication

  • Black-and-blue around the incision, bleeding from the incision, or swelling in the scrotum

  • A fever above 100.2°F, chills, or greenish or foul-smelling drainage from the incision

Risks of Varicocele Repair

Risks and possible complications of these procedures include:

  • Hematoma (blood clot)

  • Infection

  • Injury to scrotal tissue or structures

  • Injury to the artery that supplies the testicle

  • Risks of general anesthesia, if used

  • Damage to abdominal structures (laparoscopic surgery)

 

Publication Source: Dogra V, Bhatt S, Radiologic Clinics of North America 42(2), Acute painful scrotum, Mar 1 2004, pp 349-363
Publication Source: Schneck FX, Bellinger MF, Campbell-Walsh Urology, 9th ed., Chapter 127 – Abnormalities of the Testes and Scrotum and their Surgical Management, 2007, pp 3794-3797
Online Medical Reviewer: Gomella, Leonard MD
Date Last Reviewed: 10/14/2005
Date Last Modified: 10/14/2005