Varicocele is a kind of condition that affects approximately 15% of males. Just like how people develop varicose veins in the legs, varicocele develops when veins in the scrotum enlarge. The enlargement of veins happens when the blood flows in the opposite direction causing a blood-pool in the veins. This causes the veins to enlarge. They are called pampiniform plexus.
Usually, there are no symptoms associated with varicocele as such. Few signs may be noticed like heaviness in the scrotum, feeling of a lump in the testicle and so on. In such a case, it is advisable to consult a doctor and look for various options that are available. In case of mild or occasional symptoms, one can take the following steps to ease the discomfort-
- Consider wearing a jockstrap while exercising or when you need to stand for prolonged time.
- Avoid activities that cause discomfort
- Apply ice to the scrotum/groin
- One may take occasional over the counter pain relief medicines like ibuprofen or acetaminophen.
This article will help us to understand what kind of treatment is required in different cases. Varicoceles often do not need any treatment unless the following-
- Fertility problem
- Left testicle growing more slowly than the right one
If you are diagnosed with varicocele, you will be faced with what decision to make and what is the most appropriate step to take in order to treat your condition.
The following are the ways to treat Varicocele:
- Surgical ways- open surgery & laparoscopic surgery
- Varicocele Embolization (non-surgical)
- Medical Therapy- In some cases, occurrence of varicocele may cause impair to the production. Though there are no effective medical treatments available yet, researchers are evaluating the effect of antioxidants in the treatment of elevated levels of reactive oxygen species.
Apart from the surgical methods there are other non-surgical ways to treat varicocele. One can opt for varicocele natural treatment to avoid surgeries and the risk associated with it.
Let us now get into the details of the surgical method. The primary form of treating varicocele remains surgery. The most common surgical approaches used to treat varicocele are-
- Inguinal (groin)
- Retroperitoneal (abdominal)
- Infrainguinal/subinguinal (below the groin)
Open Surgery-As per reports, open surgery with the help of microscope and subinguinal methods have the highest success rate as compared to the other methods.
When performing an open surgery, the doctor will usually do it on an outpatient basis, under general or local anesthetic. The surgeon may approach the vein through the groin. However, there is a way to make an incision in the abdomen or below the groin.
Advances in the medical field have reduced the post-surgical complications. On such advancement is the use of microscope, with the help of which the surgeon can have a better visibility during the surgery. A Doppler ultrasound is also used to assist the surgeon during the procedure.
- One needs to spend the day of the surgery and the next one lying down/ reclining at home.
- Patient may walk around gently in the house in order to exercise the calf muscles and to use the washroom or to eat.
- Patients should consume well-balanced diet after returning home. One should start with fluids and gradually proceed to having solid foods.
- While reclining or lying down, remember to exercise your calf muscles every hour. Keeping the calf muscles active will prevent from blood clots to form in the leg veins.
- Mild discomfort/pain may be experienced post-surgery. But not in all the cases. Reports suggested that only 5 or less patients out of 10 report pain.
- Under the supervision of the doctor one may take nonsteroidal anti-inflammatory to relieve pain.
- Applying ice pack to the scrotum and the incision area prove to be helpful few days after the surgery.
- It is advised to elevate the scrotum on a small towel while one is lying down to prevent swelling and discomfort.
- It is best to wear a scrotal support when you are first few weeks into the surgery while standing, walking or exercising. It will help in keep discomfort away.
- The incision is covered with steri-strips and a gauze dressing. 2 days after the surgery one can remove the gauze dressing and take a shower. However, the strips should be left over until they fall off.
- Avoid lifting heavy objects after the surgery for at least a week post-surgery. Also avoid standing for extended period of time.
- If you wish, you can exercise a bit after one week. But remember not too go “all out” for another 2 weeks.
- After 1-2 weeks you can resume sexual activity as well.
Laparoscopic Surgery- Under the laparoscopic method, the surgeon will make a small incision in the patient’s abdomen and pass through a small instrument to see and repair the varicocele. This method of surgery is done under general anesthesia.
With advancement in the medical fraternity, many surgeons make only a small incision through the cut for conducting the open surgery. As a result, the healing time and pain are same with the open and laparoscopic method. Serious problems after surgery are rare (less than 1%). They include-
- Varicocele remaining or occurring again
- Formation of fluid around the testicles, called hydrocele
- Injury to the testicular artery
Following the surgical procedure, 66-70% of patients have reported improved bulk semen parameters. Also 40-60% of the patients have shown increased conception rates. (emedicine.medscape.com). It takes around 3 months for new sperms to form and hence, the improvements in the sperm analysis can be seen only after 3-4 months after the surgery.
This was all about surgical method to treat varicocele. It is always advisable to follow what your doctor had to say and act accordingly. In this article we have tried to bring to light all the necessary information with regards to varicocele and its surgical treatment.