Varicocele surgery is usually indicated when a man experiences testicular pain that does not go away with medications, infertility or when low testosterone levels are detected in plasma. Not all men with varicocele need surgery, as most of them have no symptoms and maintain normal fertility.
Surgical correction of varicocele leads to an improvement in sperm parameters, leading to an increase in the total number of moving sperm and a reduction in oxygen-free radical levels, leading to better sperm function.
- There are several surgical techniques for the treatment of varicocele.
- However.
- Open inguinal and subguinal surgery is the most used.
- Due to the high success rate.
- With minimal complications.
- Learn more about varicocele and learn how to identify symptoms.
Open surgery, although technically more difficult to perform, generally has better results in varicocele healing in adults and adolescents and minimal complications, with a lower relapse rate and lower risk of complications. In addition, it is the surgical procedure that is associated with higher rates of spontaneous pregnancy, compared to other techniques.
This technique is performed under local anesthesia and allows identification and preservation of the testicular artery and lymph vessels, which is important to prevent testicular atrophy and hydrocele formation. Know what it is and how to treat hydrocele.
Laparoscopy is more invasive and complex compared to other techniques, and the most commonly associated complications are damage to the testicular artery and lymph vessels, among other complications. However, it has the advantage of treating bilateral varicocele at the same time.
Although it allows for further expansion compared to other techniques, cremasteral veins, which can contribute to the recurrence of varicocele, cannot be treated with this technique. Other drawbacks include the need for general anesthesia, the presence of a competent and experienced laparoscopic surgeon and high operating costs.
Percutaneous embolization is performed on an outpatient basis, under local anesthesia, and is therefore associated with faster recovery and less pain. This technique poses no risk of hydrocele formation, as it does not interfere with the lymph vessels. However, it has some drawbacks, such as radiation exposure and high costs.
This procedure is intended to interrupt blood flow to the dilated vein of the testicle. To do this, an incision is made in the groin, where a catheter is inserted into the dilated vein, and then embolization particles are injected, which block the passage of blood.
In general, varicocele treatment significantly improves sperm concentration, mobility and morphology, and the seminal parameters improve approximately three months after surgery.
After surgery, the patient can usually return home the same day. Some precautions should be taken, such as avoiding stressful activities in the first month after surgery, changing dressings, and using pain relievers, as directed by your doctor.
Return to work should be evaluated during consultation with the urologist during the examination of the surgery, and sexual activity may resume after 7 days.