A varicocele is swelling of veins in the scrotum and it can be repaired with surgical procedure called varicocelectomy. This swelling occurs due to blood backing up in the veins. In some cases, it can cause pain or heaviness in scrotum. Men may also face fertility problem as it causes lower sperm count and poorer quality sperm. varicocele injury or damage may also make the testicles soften and shrink. If there is no pain or infertility problem caused by varicocele, then medical treatment is not always necessary. Surgery is done to cut the swollen veins and closed off the ends. Blood supply is carried on by other veins in the groin area. There are different treatment options available for treating varicocele depending on the symptoms and severity of the condition such as laparoscopic varicocele surgery, open microsurgical surgery or embolization.
Laparoscopic varicocelectomy is done by surgeons who specialize in urologic surgery. It is also known as keyhole surgery that involves few small cuts whereas in traditional varicocelectomy, one long incision is made near the top of the penis. There are many advantages of laparoscopic varicocelectomy when compared to traditional open surgery procedure such as:
• Increased magnification
• More accurate identification of vessels
• Much safer
• Both side varicoceles can be repaired at the same time without requiring more incisions
• Faster recovery
• Shorter hospital stay
• Shorter surgery time
• Less scarring
At the time of consultation, patient should inform the doctor in case he is taking any medicines. Doctor may suggest discontinuing some of them to avoid any complications during the surgery.
During the surgery, patient will be given general anesthesia through intravenous line, some antibiotics and other medications to avoid infection and blood clotting. A thin catheter will be placed in the bladder to drain fluid. Surgeon will make few small incisions in the abdomen and will insert a thin scope with the attached camera called laparoscope through one of the incisions which sends live images of the inside of the abdomen to video screen. The abdomen will be filled with gas to make more space for doctor to work on. Swollen veins will be cut and ends may be sealed or cauterized through other instruments placed inside through the other incisions. After completing the surgery incisions will be closed with stitches or staples.
Patient will be shifted to recovery room untill the anesthesia wears off. Doctor will give some medicines to manage any pain. The catheter will be removed from the bladder. Patient is allowed to go back home same day but should not drive. Doctor will give some instructions to the patient like avoiding sex for 1 or 2 weeks, should avoid lifting heavy weights, strenuous activities, should take stool softeners to avoid straining while passing stool, keep incision wounds clean and dry to avoid any infection.
There are some risk and complications involved in this minimal invasive laparoscopic surgery that may include:
• Blood clots
• Unexpected bleeding
• Recurring varicocele
• Hydrocele (fluid around a testicle)
• Not able to restore fertility
• Shrinkage of a testicle
• Damage or injury to surrounding nerves, blood vessels, or organs
• Temporary decrease in sperm count
• Chronic pain
• Reaction to anesthesia
Patient should immediately inform the doctor in case he may experience:
• High fever
• Swelling, redness or foul smelling drainage
• Unmanageable pain
• Difficulty in passing urine
• Pain or swelling in the legs