Varicocoelectomy

Varicocoelectomy

Varicocoeles are abnormally dilated veins found in the scrotum. Varicocoele surgery is normally performed to improve fertility, but may also be indicated to relieve varicocoele-related pain and discomfort in the scrotum. A small groin incision 2 cm long is made and the large veins within the spermatic cord isolated. With the help of an operating microscope, these abnormal veins are dissected out and tied. The advantage of using the microscope is the lower recurrence rate and lower risk of injury to the testicular arteries. The surgery takes 1½ hours.

If done for subfertility, some 70% of men should find improvement in their sperm quality.

Complications include:

  • scrotal swelling. This is expected because blood flow out of the scrotum is interrupted. The ligated veins subsequently clot to cause a cord-like swelling. The swelling should subside within a month.
  • damage to testicular artery. This occurrence should be <1% and is due to inadvertent injury of the testicular artery. Rarely, the testicle may shrink due to interrupted blood supply.
  • hydrocoele. This is excess fluid collection within the scrotum due to interruption of the lymphatic drainage
  • recurrence. This occurs in <5 % of cases and can be due to veins that drain into the scrotum. These veins lie outside the spermatic cord and hence, are not easily seen.