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Varicocele Surgery Procedure, Recovery & Complications

 

Varicocele surgery, as the name suggests, is the surgical procedure to treat enlarged veins in the scrotum. Varicocele is a common urological issue in male reproductive health. Most men avoid discussing it, as they consider it 'embarrassing'. However, this condition is quite common and can affect anyone. 

Varicocele is a condition in which the veins in the scrotum i.e. the sac that holds the testicles, increase in size due to poor functioning of the valves. This condition usually affects men between 15-25 years of age and happens to be one of the leading causes of infertility in men.

 

The severity of the condition is divided into 3 grades: 

Grade 1: In this grade, the dysfunctional veins in the scrotum are not visible. The doctor performs a diagnosis to detect them, and the patient performs a Valsalva maneuver i.e., a breathing exercise used for diagnosis. 

Grade 2: Even in grade 2, the veins aren’t clearly visible However, the doctor can feel them without requiring a Valsalva maneuver. 

Grade 3: In this grade of the disease, the doctors can identify this condition through the scrotum. A physical exam or Valsalva maneuver is not needed. 
 

When Is Varicocele Surgery Required?

Varicoceles are generally harmless and do not cause pain, discomfort, or other issues. However, in some cases, they can cause some complications and may require surgery. Consult a vascular surgeon for your varicocele treatment if you experience the following: 

  • Visible lump or swelling in the scrotum
  • Dull and recurring pain in the scrotum
  • Swelling and intensifying pain around the scrotum
  • Visibly twisted veins in the scrotum
  • Feeling of heaviness in the testicles
  • Infertility

 

Diagnosis Before Varicocele Surgery

Before varicocele surgery, the vascular surgeons assess the grade of the condition with the help of some diagnostic tests. These diagnostic tests allow the surgeons to chalk out the most suitable treatment plan for the patients. Typically, the surgeons perform the following tests before varicocele surgery: 

Valsalva Maneuver: This is a breathing technique that helps the surgeon assess the issues related to the autonomic nervous system. In this test, the doctor asks the patient to breathe out strongly through the mouth while holding the nose tightly. The patient performs this breathing technique in a standing position. Breathing in the aforementioned manner exerts pressure on the chest and helps the doctor check for abnormal enlargement of the veins in the scrotum. 

Scrotal/Doppler Ultrasound: This is another commonly performed test for varicocele. It uses sound waves to produce images of the organs inside the body. This test allows the doctor to figure out the direction of blood flow in the scrotal veins and classify the varicocele based on the size of the lump. The doctor can thereby determine the size of the veins in the scrotum.

Scrotal Infrared Digital Thermography: This method is used to detect the presence of a varicocele in its early stage. It's a non-invasive diagnostic method that measures the temperature of the skin surface surrounding the scrotum. This thermography of the scrotum helps the doctor diagnose low-grade varicoceles. Additionally, scrotal infrared digital thermography is also used as part of follow-up diagnostic tests after varicocele surgery. 
 

What Are The Different Types Of Varicocele Surgeries?

After performing a thorough diagnosis of the condition, the surgeon might suggest one of the following surgeries for your varicocele treatment. Generally, there are three types of varicocele surgeries: 

Microscopic Varicocele Surgery: This is the traditional, open surgery for varicocele. It is performed under local or general anesthetic to keep the patient at complete ease during the procedure. In this procedure, the surgeon enters the affected area through the groin, or in some cases, through the upper thigh or abdomen. Then, they use ultrasound and surgical microscopes to close the affected veins and reroute the blood through healthier blood vessels. Generally, patients feel little to no pain after the surgery and can resume their normal activities in just a couple of days. 

Varicocele laparoscopic surgery: For patients diagnosed with second or third-grade varicoceles, laparoscopic surgery is considered the most effective. This patient is sedated with general anesthesia before the surgery. In this procedure, the surgeon makes small incisions in the abdomen and inserts a laparoscope i.e., a thin lighted scope. Then, the he/she inflates the area with CO2 gas, which allows the surgeon to get a clear view of the organs inside. The surgeon then identifies the swollen veins, cuts them, and then seals the end. After sealing the ends, the surgeon removes the tools and closes the incisions with sutures or clips. 

Percutaneous Varicocele embolization: This is a minimally invasive method of varicocele treatment which involves the insertion of a tube or catheter into the body through the neck or groin. In this procedure, the surgeon diverts the blood from an enlarged vein in the scrotum. This method is less invasive than the other methods and is performed on an outpatient basis. Additionally, the varicocele surgery recovery time is also quite short. 

 

How To Prepare For Varicocele Surgeries?

Preparing for a varicocele surgery can benefit you in more ways than one. It will help you remain calm during the procedure and also lets you avoid any complications at the time of surgery. Here are some ways in which you can prepare for your varicocele surgery: 

  • Talk to your surgeon about any medications you have been taking before going ahead with the surgery.
  • The varicocele repair treatment is usually performed through the groin area. Therefore, it would be preferable if you shave the treatment area before appearing for surgery.
  • Avoid consuming any food or liquids before the surgery. This is done to avoid any reaction to anesthesia, which can lead to choking out stomach contents during the surgery.
  • We suggest taking a shower before the surgery as the doctor would ask you to keep the surgical area dry. This will help in eliminating the risk of infections after the operation. 
  • Refrain from taking certain medications like aspirin, diabetic drugs, blood thinners, and other nonsteroidal anti-inflammatory drugs to rule out the possibility of any complications.
  • If you are allergic to Anesthesia, make sure you inform your doctor beforehand. This will prevent you from developing any potential reactions to anesthesia during the treatment. 


What Will Happen After The Surgery?

Here's what you can expect after your varicocele surgery: 

1) On completion of the varicocele surgery, the surgeon will keep you under observation until the effect of anesthesia wears off completely. 

2) Once the effect of the anesthesia has completely subsided, the staff will move you to a ward and monitor your health vitals. 

3) You may experience some pain and swelling in the groin after the surgery, however, the doctor will prescribe medicines for pain management. 

4) After monitoring your overall health condition, and ensuring that there are no complications, the doctor will discharge you from the hospital. 

5) You will be asked to keep the surgical area clean and dry for a couple of days after the surgery. This will help you in preventing the risk of infections. 

6) You will be able to spot varicocele surgery before and after difference after the healing process is complete. 

How To Care After Varicocele Surgery?

After the procedure is complete, the patients must take proper measures to avoid post-surgery complications. Here are some post-surgery care tips that all patients must follow:

Wound Care: Taking proper care of the wound after varicocele surgery is essential in order to prevent infections. Keep the incision covered with dressing for at least two days after the surgery. Replace the dressing with a fresh one if you notice any discharge from the wound. Additionally, if the surgeons have used any glue on the stitches, avoid picking it out on your own.

Eat Lite: It's normal for patients to feel nauseous after varicocele surgery. This is generally caused due to anesthesia. Therefore, doctors suggest eating light and healthy after the surgery as it helps manage these symptoms. 

Do Not Indulge In Strenuous Activities: It goes without saying that strenuous activities can put you at the risk of pressurizing or straining the scrotal region. This can cause excessive pain and may also slow down the healing process. Therefore, avoid strenuous activities for a couple of weeks after the varicocele surgery to avoid complications. 

Say Hello To Loose Fitting Clothes: Tight-fitted clothes can irritate the groin area. Therefore, wear loose-fitting clothes for a couple of days after the surgery to speed up the healing process. 

Keep The Scrotal Region Elevated: Most patients would feel minor swelling and pain after their varicocelectomy surgery. However, it's common and not very serious. You can manage it easily by elevating your scrotal region. This helps increase the blood flow to the scrotum and relieve pain and inflammation.

Scrotal Support: Scrotal Support or jockstrap can help minimize the pressure on the scrotal region and can help you perform your daily tasks with much more ease. 

Take your medicines on time: After surgery, the doctor will prescribe some medicines to help you with pain management. So, make sure that you take the prescribed medicines on time and as prescribed. Also, avoid taking any medicines before consulting your doctor. 
 

What Are The Risks Factors Associated With Varicocele Surgery?

The varicocele surgery success rate is quite high. However, like any other surgery, this surgery can also lead to some complications. Listed below are some complications that can occur after a varicocele surgery: 

  • Hydrocele i,e., fluid buildup around your testicle.
  • Drainage from the incision, along with redness or inflammation. 
  • Abnormal swelling that does not go away on its own.
  • Difficulty emptying bladder
  • Infection and fever
  • Nausea
  • Leg pain or swelling

If you experience any of these symptoms, immediately get in touch with your healthcare provider.

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