What is a varicocele
A varicocele is an enlargement of the network of veins that drain blood from the testicle. When the valves in these veins do not work properly, blood is retained and the veins widen, so a feeling of lumps or a cluster in the scrotum arises. It most often appears on the left side, due to the anatomical characteristics of the venous network, but it can be bilateral as well.
This condition is often discovered in adolescence and in younger men, sometimes by chance during an examination. A varicocele can be of various degrees, from barely noticeable to pronounced, which is easily felt or even seen.
In many men a varicocele causes no symptoms and does not require treatment. In others it causes pain, a feeling of heaviness or is linked to reduced fertility, because the enlarged veins can raise the temperature in the scrotum and affect the testicle.
When a varicocele causes symptoms or is associated with fertility problems, surgery is considered that interrupts the flow through the enlarged veins. This relieves the venous network, and blood continues to drain through healthy pathways.
When varicocele surgery is indicated
Surgery is not recommended for everyone who has a varicocele. In men without symptoms and without fertility problems, monitoring is often enough. The decision to operate is made when the varicocele causes symptoms or is linked to reduced fertility.
The doctor assesses the degree of the varicocele, the presence of pain, the appearance and size of the testicle, as well as findings related to fertility. In younger patients special attention is paid to whether the varicocele affects the growth of the testicle.
- A dull pain or feeling of heaviness in the scrotum that intensifies during the day
- A visible or palpable cluster of enlarged veins in the scrotum
- Discomfort with prolonged standing or physical strain
- Reduction or lag in the growth of the testicle on the affected side
- Fertility problems and a poor semen analysis result
- A feeling of tightness that eases when you lie down
- A pronounced varicocele visible to the naked eye
- Symptoms that interfere with daily activities
How varicocele surgery is performed
The goal of the operation, which is called varicocelectomy, is to interrupt the enlarged veins through which blood is retained, while preserving the artery, lymphatic vessels and other important structures. This restores tidy drainage of blood from the testicle.
There are several approaches. The microsurgical technique uses magnification to precisely recognize and tie off only the enlarged veins, with maximum preservation of the surrounding structures. Depending on the findings and the surgeon's assessment, other techniques are also possible, of which the patient is informed in detail before the procedure.
The choice of approach is adapted to each patient, with the aim that the symptoms disappear while the risk of recurrence and complications is as low as possible. The surgeon explains which approach is most suitable for you and why.
Precise recognition and preservation of the artery and lymphatic vessels is key, because it reduces the possibility of complications and preserves the function of the testicle. That is exactly why the microsurgical approach, when indicated, is performed patiently and carefully, step by step.
Preparation
Preparation includes an examination and ultrasound of the scrotum, which confirm the varicocele and assess its degree. When the reason for surgery is fertility, the workup also includes a semen analysis and, if needed, additional findings. The anesthesiologist assesses the general condition before the procedure.
An open conversation with the doctor is an important part of preparation. Tell everything concerning your health, previous surgeries and medications, so the team can plan the safest course.
- Tell the doctor about all medications you take, especially blood thinners
- Report allergies, chronic illnesses and previous surgeries
- Bring the ultrasound findings and, if you have one, a semen analysis
- Follow the instructions on fasting before a procedure under general anesthesia
- Prepare comfortable underwear that supports the scrotum for the recovery period
- Arrange accompaniment for the return home after the operation
The procedure, anesthesia and duration
Varicocele surgery is performed under general or another type of anesthesia, which the anesthesiologist decides in agreement with the patient. The procedure is performed through a small incision, and the enlarged veins are carefully recognized and interrupted.
The procedure is usually one of the shorter operations, and the exact duration depends on the technique applied and on whether one or both sides are operated on. The microsurgical approach involves careful, precise work under magnification.
After the operation the patient is monitored in a recovery room. In a great many patients this is a procedure after which you go home the same day, with clear recommendations for recovery and follow-ups.
Recovery
Recovery after varicocele surgery is, for most men, quick. In the first days mild pain, a feeling of tightness and minor swelling of the scrotum are usual, which is well controlled with prescribed therapy and rest. Wearing underwear that supports the scrotum contributes to comfort and reduced swelling.
The return to lighter activities is usually possible after a few days, while strenuous physical work, the gym and sport are postponed on the doctor's recommendation. When the operation was done for fertility, changes in the semen analysis findings are assessed only after a certain time, because the body needs to adjust.
At the follow-up examinations the team checks the healing of the wound and the subsiding of the swelling, and for patients operated on for fertility a time for a repeat semen analysis is agreed. Following the recommendations in this period contributes to a calm recovery and a better final result.
- Wear underwear that supports the scrotum according to the instructions
- Avoid strenuous physical work and lifting in the first days
- Postpone sport and the gym until the doctor allows it
- Keep the wound clean and dry
- Take the prescribed pain therapy as needed
- Contact the doctor if swelling, redness or pain increase markedly
Possible risks
Varicocele surgery is a safe and common procedure, but like any operation it carries certain risks. With an experienced team and modern techniques, serious complications are rare, and most transient discomforts resolve during recovery.
Before the operation the surgeon explains the risks in relation to the chosen approach and your condition, so you can make an informed decision.
- The formation of a collection of fluid around the testicle, a so-called hydrocele
- Recurrence of the varicocele
- Swelling and bruising in the scrotum area
- Wound infection
- Bleeding or the formation of a hematoma
- The usual risks related to the applied anesthesia
Why Medical Time
At Medical Time in Belgrade we approach varicocele surgery carefully and individually, from accurate diagnostics to the choice of technique that best suits your case. Our goal is the removal of symptoms, care for fertility and a calm recovery.
- An experienced surgical team and modern techniques
- The possibility of a microsurgical approach in suitable patients
- Detailed diagnostics of the scrotum before the operation
- Attention directed at fertility and the long-term result
- Clear recommendations for recovery and follow-ups
- A discreet and understanding approach to the patient
Price — varicocele
The price of varicocele surgery depends on the chosen surgical technique, on whether one or both sides are operated on, as well as on the type of anesthesia. The estimate is also affected by the diagnostics needed before the procedure, the ultrasound, the semen analysis and the monitoring after the operation.
We determine the final price and plan of the procedure after an examination and review of the findings, because every case is different. At the consultation you receive a clear picture of the proposed technique and everything it involves.
- Consultation and examination
- Scrotal ultrasound and preoperative workup
- Surgery with anesthesia
- Follow-up examinations after the procedure
For an individual estimate and an appointment, call 062-399-888.
Frequently asked questions
No. In men without symptoms and without fertility problems, monitoring is often enough. Surgery is recommended when the varicocele causes pain or is linked to reduced fertility.
In some men the operation can have a positive effect on the semen analysis, but the result is not guaranteed and is assessed only after a certain time. The doctor realistically explains what you can expect.
The reason lies in the anatomical characteristics of the venous network on the left side, which cause blood to be retained more easily. A varicocele can still occur on the right side or be bilateral.
In a great many patients this is a procedure after which you go home the same day. The final assessment is given by the team in relation to the technique, anesthesia and your condition.
You usually return to lighter activities after a few days, while sport and the gym are postponed until the doctor allows it. Following these recommendations reduces the risk of complications.
Recurrence is possible, but modern techniques reduce it to a minimum. If the symptoms return, contact the team for an assessment.
You book a consultation at Medical Time in Belgrade by calling 062-399-888. At the examination we assess the findings and propose a further plan.