Varicocele surgery is usually indicated when the man feels testicular pain that does not go away with medication, in cases of infertility or when low levels of plasma testosterone are detected. Not all men with varicocele need to undergo surgery, as most of them have no symptoms and maintain normal fertility.
Surgical correction of varicocele leads to an improvement in semen parameters, leading to an increase in the total number of mobile sperm and a reduction in oxygen free radical levels, leading to a better functioning of sperm.
There are several surgical techniques for the treatment of varicocele, however, open inguinal and subinguinal surgery is the most used, due to the high success rate, with minimal complications. See more about varicocele and learn how to identify symptoms.
1. Open surgery
Open surgery, although technically more difficult to perform, usually has better results in curing varicocele in adults and adolescents and minimal complications, presenting a lower relapse rate and less risk of complications. In addition, it is the surgical procedure that is associated with higher spontaneous pregnancy rates, compared to other techniques.
This technique is performed under local anesthesia and allows the identification and preservation of the testicular artery and lymphatic vessels, which is important to prevent testicular atrophy and hydrocele formation. Know what it is and how to treat the hydrocele.
2. Laparoscopy
Laparoscopy is more invasive and more complex in relation to the other techniques and the complications that are most often associated with it are injury to the testicular artery and damage to the lymphatic vessels, among other complications. However, it has the advantage of simultaneously treating bilateral varicocele.
Despite allowing greater expansion in relation to other techniques, cremasteral veins, which can contribute to the recurrence of varicocele, cannot be treated by this technique. Other disadvantages include the need for general anesthesia, the presence of a surgeon with skill and experience in laparoscopy and high operating costs.
3. Percutaneous embolization
Percutaneous embolization is performed on an outpatient basis, under local anesthesia and, therefore, is associated with faster recovery and less pain. This technique does not present a risk of hydrocele formation, since there is no interference with the lymphatic vessels. However, it has some disadvantages, such as radiation exposure and high costs.
This procedure aims to interrupt the flow of blood to the dilated vein of the testis. For this, a cut is made in the groin, where a catheter is inserted into the dilated vein, and then embolizing particles are injected, which block the passage of blood.
Generally, the treatment of varicocele significantly improves sperm concentration, mobility and morphology, and seminal parameters improve around three months after surgery.
How is recovery from surgery
After surgery, the patient can usually go home on the same day. Some precautions should be taken, such as avoiding activities with effort in the first month after surgery, changing dressings and using pain medications, according to the doctor's guidance.
The return to work should be evaluated during the consultation with the urologist, in the review of the surgery, and sexual activity can be resumed after 7 days.
