Varicocelectomy

A varicocele happens when veins inside a male's scrotum —  the pouch of skin that holds the testicles —  becomes enlarged. The condition is similar to varicose veins in a leg.

Varicoceles generally form during puberty. They are relatively common — they happen in about 15 out of every 100 males — and are often harmless and cause no symptoms. When they happen in boys, there's a small chance one testicle will grow more slowly than the other.

In some cases, they can cause pain or male infertility.

In some cases, a varicocele can affect semen quality and sperm production. You may learn of a varicocele only after you've had a semen analysis done. Your doctor may also recommend another semen analysis after varicocele repair, to see whether it has improved your sperm production and semen quality.

Varicocele surgery repairs the enlarged veins and the varicocele.

There are two surgical approaches, both of them performed on an outpatient basis:

Open surgery: This is more common. The surgeon makes a small cut and may use an operating microscope to see the veins. The surgery clips or ties off the affected vein, which redirects blood flow into other normal veins. The surgery can be done under general anesthesia or local anesthesia.

Laparoscopic surgery: In this procedure, your surgeon makes a small incision in your belly then passes very small surgical instruments through the incision, including a small tube with a camera. This allows the surgeon to see the affected veins and repair them with the instruments. This procedure is generally performed under general anesthesia.

More rarely, a procedure called a percutaneous embolization is performed for varicocele repair. A small tube is inserted into a vein in your groin or neck. Instruments passed through that tube, including a small camera, allow the doctor to release coils or a special solution that blocks off the affected veins and repairs the varicocele. The procedure is generally done under general anesthesia and can take several hours.

In the first day after the surgery, you should remain lying down or reclining at home.

Gauze dressing and small pieces of tape called steri-strips will cover the incision. You can remove the dressing two days after surgery. Leave the steri-strips on until they fall off, usually a week or two after the surgery.

You may have minor to moderate pain. Your doctor may prescribe medication for a short time after the surgery. After that, you can take pain relievers like acetaminophen or ibuprofen.

Recovery time varies, but you likely will be able to return to work and most normal activities within a couple days. For one to two weeks you should avoid:

• sex
• exercising
• heavy lifting

The surgery presents few risks. In rare cases, there can be:

• Infection
• Surgical damage to an artery in the testicle
• Fluid accumulation around the testicles
• A recurrence of varicoceles

Sources:
https://www.urologyhealth.org/urologic-conditions/varicoceles
https://my.clevelandclinic.org/health/diseases/15239-varicocele
https://www.mayoclinic.org/diseases-conditions/varicocele/diagnosis-treatment/drc-20378772