Varicocele surgical options have been discussed by surgeons for over 2000 years and the quest is still on to find the best and the most simple procedure to cure this benign and low morbidity condition that affects men.
Indications for Surgery for Varicocele
1. Pain or ‘uneasiness’ or ‘dragging sensation’ in the scrotum.
2. Cosmetic appearance – unsightly appearance of a ‘bag of veins that looks like worms’on the scrotum can upset a young man.
3. Low sperm count with visible varicocele
4. Small size of the testis in comparison to normal side
The surgery can be done via a laparoscope or by a technique called microsurgical technique. In this the veins are visualized under a microscope and then ligated. There is also an embolisation procedure that can be employed to block off the veins by means of an embolus. Instead of embolising by means of a coil, a sclerosant can be injected to cut off the offending vein.
Advantages of Microsurgery:
• Visualization is improved and therefore preserving blood supply by avoiding ligation of the artery and future arophy of the testes.
• Preserve the lymphatics and therefore prevent hydrocele formation.
• Better visualization avoids future recurrence.
Not all varicoceles require surgical operation.
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