Varicocele surgery

Varicocele is formed by dilation of the blood vessels responsible for draining testicular blood. Its appearance is due to dilation of the veins in the testicles, which can cause lesions in the testicles and serious fertility problems in men who suffer from it. It can also lead to a decrease in the size of the testicles, which is why Varicocele surgery is highly recommended.

To solve a varicocele, the best option is the varicocele operation, a surgical treatment. Below we explain all the details about this surgical procedure and how to manage it through Operarme.

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Varicocele is a dilatation of the blood vessels whose function is to drain blood from the testicles, medically known as the pampiniform plexus.

It is caused by a backflow of blood from the renal vein into the testicle, resulting in varicose dilatation of the testicular veins and consequently damage to the functioning of the testicles due to loss of blood flow.

Varicocele is the swelling of the veins that run along the spermatic cord.

This deterioration of testicular function is progressive and worsening, and poses a risk to a man's fertility. This statement is supported by several research studies, including the WHO (World Health Organisation), which confirm that varicocele seriously affects male fertility, with the incidence of varicocele being more frequent in infertile men than in the general population.

Symptoms of varicocele

As we have already mentioned, the swelling and dilation of these veins is similar to that which appears in legs with varicose veins. 

The main problem with varicocele is that due to the dilation of the veins of the spermatic cord, the blood flow to the testicles is reduced, affecting their functionality. Some of the symptoms of this loss of blood supply are:

• Reduction in the size of the testicle. Due to the reduction in blood flow to the testicle, there is a lesion in the hypothalamus-pituitary-testes axis which leads to a decrease in the production of testosterone and a consequent reduction in the size of the testicles.
• In the same way that the reduction in blood flow leads to a reduction in the size of the testicle, it also prevents the testicles from functioning properly, hindering spermatogenesis, the formation of spermatozoa, which causes fertility problems in men.
• Alteration of the genetic load. This is one of the most serious problems that varicocele can cause. Due to the aforementioned loss of blood flow, there is a possibility that the genetic load generated in the testicles may be altered and lead to possible malformations.
• Pain and heaviness. These symptoms are uncommon but possible. They manifest themselves as discomfort in the groyne area or in the testicles without being clear what the cause is, as well as a feeling of heaviness due to dilation of the veins of the spermatic cord.

Do symptoms improve after varicocele surgery?

After varicocele surgery, the blood flow that had been altered improves and with it, the symptoms of pain and heaviness, if any, and the man's fertility.

In addition, there are many cases of unfruitful pregnancy attempts that are solved thanks to varicocelectomy in men.

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How is varicocele diagnosed?

Since in most cases varicocele is asymptomatic, it is usually diagnosed when the urologist performs a scrotal examination of the patient to study infertility, or on the other hand, non-specific inguinal or testicular discomfort.

The sensation perceived by the specialist during the scrotal exploration is that of a small tumour in the area of the spermatic cord.

If the varicocele is not operated on and the progressive deterioration of testicular function continues, various problems mentioned above may occur. These may include damage to the hypothalamus-pituitary-testes axis, leading to problems in spermatogenesis, which is the formation of spermatozoa, in both testicles, as well as a decrease in testosterone production.

After the surgery, the sperm count improves by 60-70% and the chances of pregnancy by 50%.

In addition to these fertility problems, varicocele causes a decrease in the size of the testicle as well as an alteration in the genetic load of the spermatozoa, which is why the operation is more than recommendable if you want to have children and prevent the size of the affected testicle from being excessively reduced.

At Operarme the surgical assessment consultation with the specialist is free of charge and there is no waiting time. The specialist will review your case, so it is important that you come with all the medical reports and tests you have in order to confirm the diagnosis.

During the face-to-face consultation, you will get to know the doctor and you will be able to ask him or her all the questions you need, so that together you can make the decision to carry out the varicocele intervention in the correct way.

To request a consultation with the specialist at Operarme, you can do so directly by clicking on Make an appointment, calling at +34 91 141 33 56 or requesting it via this contact form. 

Once the appointment has been requested, our patient service team will contact you to confirm that the time and date of the appointment suits your schedule, as well as to give you all the information you need about the steps to follow.

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Consultation for assessment with the Urology Specialist

On the day indicated for the appointment with the Urology specialist, you should come to the consultation with all the tests and medical reports he/she has on your varicocele problems. 

This is vital so that the doctor has the necessary information to determine the seriousness of the case and whether or not varicocele surgery is required. Otherwise, it is likely that a diagnosis cannot be made and further testing will be necessary.

During your consultation, the doctor will ask you a series of questions about your condition in order to determine whether or not the intervention is feasible. Likewise, you can and should ask the doctor everything you need to know about the operation in order to make an informed and correct decision.

If both you and the doctor agree on the surgery, it is possible to set the date of the operation at the same consultation or, on the other hand, to set it with the patient care team who will call you after the assessment consultation.

If the varicocele operation goes ahead, a date will be set for the operation and the process will begin with the pre-operative procedure.

Pre-operative varicocele surgery

Preoperative varicocele surgery is always necessary and consists of 3 tests:

• Chest x-ray. This test is performed not only to check for signs of infection, but also to check that the trachea is properly aligned. It is not always requested; it must be expressly indicated by the doctor.
• Complete blood test. This test is performed to check for signs of infection, as this could lead to unwanted infections causing major complications.
• This test will allow the specialist and the anaesthetist to check the patient's cardiovascular health.
• Consultation with the anaesthesiologist: inform the anaesthesiologist if you suffer from any allergies, if you are on medication, whether prescribed or not, previous surgeries, etc. This consultation will determine which anaesthesia will be used during the operation.

If the anaesthetist gives the go-ahead for the surgery, the next step is to go to the hospital for the operation. As far as varicocele surgery is concerned, it is usually performed under regional or general anaesthesia.

Once the pre-operative procedure has been carried out, the only thing left to do is to perform the operation on the indicated day.

On the day of the operation, you will go to the hospital at the agreed time and hand in all the documentation necessary for the operation to be carried out. You will then be taken to your room until it is time for the surgery.

Before entering the operating theatre, you will be taken to a room where you will be asked to undress, remove all metallic elements you may be wearing (earrings, piercings, accessories, etc.) and you will be given your operating clothes.

Varicocele is one of the main causes of male infertility.

Once inside the operating theatre, the surgeon with whom you consulted and who is going to operate on you, the anaesthetist and a member of the nursing team will be there. The anaesthetist then administers the anaesthetic, which is usually regional in most cases, and when it takes effect, the surgery begins.

1. If necessary, the surgeon shaves the area through which the procedure is to be performed and disinfects it. He/she then makes a 3-4 cm incision in the inguinal canal.
2. Through this incision, the surgeon gains access to the interior and first of all the dilated veins of the internal inguinal ring are ligated. This separates the artery and lymphatic vessels, thus preventing the formation of hydrocele testis.
3. The surgeon then removes the inguinal cord and completely ligates the arteries, lymphatic ducts and other blood vessels.
4. Once this is done, the surgeon will stitch up the incision and apply a dressing. You will then be taken to the recovery room, where you will remain until your vital signs are fully restored.

The duration of varicocele surgical treatment is between 20 and 60 minutes.

The recurrence rate for this technique is between 8 and 10%, with hydrocele occurring in far fewer cases than in the previous technique.

Postoperative recovery from varicocele surgery is very comfortable and quick, in the vast majority of cases not exceeding 7 days.

After the operation, you may be able to leave the hospital after 4 or 5 hours, although in many cases it is decided that you will spend one night in hospital for your comfort and to monitor your progress.

Before leaving the hospital, you will be scheduled for a check-up and spermiogram (if the operation is to solve infertility problems).

During your recovery at home, you should avoid heavy physical exertion for the next 2 weeks, although you can return to work 4 or 5 days after the operation if it is an office job. In the case of a more physical job, the wait should be at least two weeks.

To care for the wound, simply wash the area carefully, apply some antiseptic to avoid infection and change the dressing until the doctor removes the stitches.

The first postoperative check-up for varicocele is performed a few days after surgery to remove the stitches.

If the operation is performed to solve an infertility problem, a spermiogram will be performed 3 to 4 weeks later to detect improvements in sperm count and semen quality.

The main advantage of varicocele surgery, a surgical treatment, is to reduce the likelihood of male infertility and prevent the damage from progressing to both testicles and affecting the creation of sperm and testosterone.

The risks are the same as for any surgery, such as those related to anaesthesia, as well as the possibility of complications and recurrence of the varicocele. Complications include:

• Hydrocele, which is fluid in the testicles.
• Scrotal haematoma, blood in the testicles.
• Testicular atrophy, shrinking of the testicle.
• Inguinal hernia.

These problems are not very common, but can occur.

The advantages of undergoing varicocele surgery through Operarme are as follows:

• The price is totally fixed and all-inclusive, with no final surprises.
• Our patient care is totally personalised.
• Our specialists in Urology are experts in their field, with a long career and outstanding professionals.

We have hospital centres equipped with the most advanced medical technologies and a privileged location in your city.

If you are thinking of alleviating your problems caused by varicocele at Operarme, remember that you can request an immediate and free surgical assessment consultation with our specialists via this contact form, by calling at +34 91 141 33 56 or directly through our website:

Do you need varicocele surgery?

Request a free and immediate appointment with our specialists in Urology

Make an appointment