Variococele Repair

Varicoceles are dilated veins in the scrotum surrounding the testes. Approximately 15% of all men have varicoceles and for most men, they do not seem to impair testicular function. However, about 40% of all men with infertility have varicoceles and it is generally believed that their presence, impairs sperm production. Although the precise pathophysiological mechanisms of the varicocele effect have not been delineated, many investigators believe that a secondary increase in testicular temperature causes impaired spermatogenesis. Whatever the cause, many studies have demonstrated that.

A varicocele is made up of enlarged veins within the scrotum. They are similar to varicose veins of the legs. Varicoceles are found in about 15% of the normal male population and about 40% of men with infertility. Most evidence indicates that varicoceles can hinder sperm production often resulting in infertility. It is important to remember that female factors can also contribute to infertility. Therefore, successful outcomes can depend on both partners being treated. Both you and your partner should have complete evaluations before any treatment choices are made.

Not all men with varicoceles are infertile. However, most infertile men with varicoceles have improvement of semen quality after varicocele repair, and some infertile men with varicoceles are able to achieve a conception after varicocele repair. Varicoceles are found by doctors on physical examination. Further tests include at least two semen analyses which may be performed to find out whether the varicocele is associated with infertility. Once an evaluation is completed, your doctor can tell you about treatment options that are available for you and your partner. To the doctor, a varicocele feels like a bag of worms when you are in the standing position.

If you and your partner are trying to conceive a child and you have been told you have a varicocele, you should think about treatment when the following are present:

1. The varicocele can be felt when your doctor examines the scrotum.
2. You and your partner have been unable to get pregnant.
3. Your partner has normal fertility or a treatable cause of female infertility.
4. Your semen analyses or sperm function tests are not normal.

There are a number of surgical options, and your doctor will discus with you the details of these approaches. Surgical repair of a varicocele is done in an outpatient surgical center with general or local anesthesia. The operation takes about an hour. Surgery for surgical correction of a varicocele is successful in 90% of cases and about 60% of men have improved sperm count and motility after repair of the varicocele. About 40% of couples will subsequently initiate a pregnancy following varicocele repair. Many urologists prefer an operative approach that employs microscopic techniques. The use of this higher magnification better ensures prevention of damage to other important structures with effective ligation of those veins contributing to the varicocele.