Treatment for Varicoceles Part 3

What can be expected after treatment?

The surgery for varicocele treatment is considered minor in nature and the incision is small. The majority of individuals recover rapidly. The pain is easily controlled with over the counter pain medications and only lasts 24 hours. All patients are asked to refrain from strenuous exercise and heavy lifting for 2 weeks. The majority of individuals can return to work in 48 hours. The surgeon will always recommend a follow up appointment in 1-2 week after the surgery. At the follow up appointment, the sperm is analyzed. Semen analyses are typically obtained at three to four month intervals after the procedure. Improvement is often seen within six months, but may not be observed until one year postoperatively.

The majority of individuals who undergo the open procedure do well and only have a recurrence rate of 1%.

Results

All the operative techniques show a good response in the short term, but the recent microsurgical techniques have the fewest complications and the fastest recovery. Despite the advent of newer laparoscopic techniques and better instruments, this technique has not been found to be superior to the open surgical techniques. The short term results are the same as the open surgery.

Today, the majority of urologists agree on one thing; only clinically visible varicoceles should be treated. The varicoceles which are small and only identified by ultrasound should be observed. No one has shown that repairing these varicoceles improves the fertility rates.

For the symptomatic and large varicoceles, there is some evidence (depending on whom you believe), that pregnancy rates are improved in the previously sterile male. In an era where money and medicine have become a business, the surgeons always claim to have great success with everything they do-so be informed and ask questions.

Varicoceles Part 2

Who develops a varicocele?

Surveys indicate that Varicoceles are common in the male population and some studies indicate that nearly 10%-20% of men develop them usually between the ages of 15-30. When the varicocele initially develops there are usually no symptoms. The majority of Varicoceles develop in the left groin. Very rarely are they present on both sides. The reason why most occur on the left side is because of the anatomical differences in venous drainage from the scrotum on the left side.

What does a varicocele feel like?

Generally one can not see a varicocele. Often when one runs the hand along the scrotum, one can feel a sensation like a "bag of worms”. The majority of Varicoceles are small and do not get large. The length of a varicocele is usually less than 1 inch.

Diagnosis of Varicocele

In most cases a physical exam will reveal the presence of a varicocele. The individual should be examined in the standing position. The bag of worms usually disappears when lying down. Often the physician may ask you to bear down (like you are pooping). This increases pressure in the abdomen and can make the varicocele visible. Varicoceles which have been present for many years often do not change with position.

Sometimes a varicocele is suspected but can not be seen. In such a case, an ultrasound will help make the diagnosis. This painless non invasive test can reveal the size of the varicosity, presence of backward blood flow and the location.