Varicocele

Diagnosis

A varicocele can be identified by visual and tactile examination of the scrotum by your doctor. Most likely, you’ll have examinations both lying down and standing up.

While in a standing position, your healthcare provider may request that you take a deep breath, hold it, and then apply pressure as if you were having a bowel movement. The Valsalva maneuver can make it simpler to evaluate a varicocele.

Imaging test

You might be asked to undergo an ultrasound examination by your doctor. Using high-frequency sound waves, ultrasound can provide images of the internal organs and other body parts. These pictures could be used for:

• Identify the varicocele or confirm the diagnosis.
• Rule out any other illness as a potential source of the signs or symptoms.
• Find any lesions or other factors preventing blood flow.

Treatment

Most of the time, a varicocele doesn’t require treatment. The treatment approach for a male with infertility may include varicocele surgery to repair the condition.

Medical professionals may recommend annual examinations for teenagers or young adults who are not actively seeking reproductive therapy to monitor any changes in their varicocele. Surgery may be recommended in the following situations:

• Chronic pain that is not controlled by painkillers
• A testicle that exhibits delayed growth
• Low sperm count or other abnormalities of the sperm (typically only examined in adults)

Surgery

Surgery’s goal is to close off the damaged vein and reroute blood flow to healthy veins. This is possible because the scrotum is supplied with blood flow by two additional artery and vein networks.

Results of treatment could include the following:

• The impacted testicle may eventually grow back to its normal size. The testicle’s development may “catch up” in the case of a teenager.
• In vitro fertilization (IVF) semen quality or fertility may be improved through surgery.
• Sperm counts could increase, and sperm abnormalities could be fixed.

Surgical procedures

By stitching or clipping the vein shut, your surgeon can block the flow of blood through the testicular vein. Today, two approaches are frequently used. Both surgeries are outpatient and call for general anesthesia; you can typically return home the same day. The steps consist of:

• Microscopic varicocelectomy. A small incision is made by the surgeon below the groin. The surgeon locates and ligates a number of tiny veins using a microscope. The operation typically takes two to three hours.
• Laparoscopic varicocelectomy. Using a video camera and surgical instruments connected to tubes that pass through a few very small incisions in the lower abdomen, the surgeon performs the procedure. There are fewer veins to ligate above the groin because the network of veins is less intricate. Typically, the operation takes 30 to 40 minutes.

Recovery

Although the pain from this procedure is typically moderate, it could last for several days or weeks. Following surgery, your doctor could recommend pain medication for a short duration. After that, your doctor might suggest that you take an over-the-counter pain reliever to ease your discomfort, such as acetaminophen or ibuprofen.

After surgery, you’ll probably be able to go back to work a week later and start exercising again two weeks later. Ask your surgeon when you can resume your normal activities or when you can engage in sexual activity without risk.