A varicocele is a varicose vein (larger than normal vein that is visible through the skin) inside the scrotum. These enlarged veins are the spermatic cord (the tube that transports sperm to the testes). Varicoceles can cause blood to collect in the scrotum or flow backward to the testes because the veins are larger than normal.
Varicoceles are extremely common—15 percent of men have varicoceles and a left-sided varicocele is much more common than a right-sided varicocele.
Are Varicoceles Harmful?
If you’re living with a varicocele, it is harmless to your health. However, a varicocele may lead to:
- reduced fertility,
- altered hormone levels, or
- scrotal pain.
About 40 percent of men who visit infertility clinics have varicoceles. These scrotal varicose veins can disrupt spermatogenesis (sperm creation). Men who have varicoceles usually have a low sperm count, reduced sperm motility (sperm activity), and abnormal sperm. But they don’t always cause infertility issues.
Preparing for Your Surgery
Follow the steps below to ensure you’re ready for surgery day.
- Eat normally the evening before your surgery.
- Do not eat or drink anything after midnight.
- Do NOT drink coffee, juice, or milk the morning of surgery.
- Do NOT eat the morning of surgery.
- If you have any medications that you must take in the morning before your surgery, swallow them with a small sip of water only.
- Wear loose, comfortable clothing.
Before we begin the procedure, we will give you general anesthesia to put you to sleep and local anesthesia to numb the area and keep you comfortable when you wake up. For the varicocelectomy, we make a 1–2 cm incision in the groin and then bring the spermatic cord up to the skin (see figure 1). We use an operating microscope to perform the varicocelectomy at 30–40x magnification.
We then open the external spermatic fascia (outside layer) under the microscope and cut out and divide each engorged spermatic cord vein. We tie off the veins with clips or ties while keeping other parts of the spermatic cord intact. We close the incision using dissolvable stitches.
The entire procedure takes 45 minutes to one hour and patients can go home the same day.
Varicocele Surgery Recovery
Most men have minimal pain after this procedure and often forget to take the pain pills that we provide.
For the first 24 hours after surgery, do not:
- use machinery,
- eat any heavy or large meals,
- drink alcohol, or
- make important decisions because the anesthesia will make it hard to think clearly.
You should recover in about one to two days. Any bruising, swelling, or pain you experience is normal and should cease after several days.
For a quick and easy recovery, you should:
- Take Ibuprofen 800mg every eight hours and Tylenol 650mg every six hours around the clock for three days.
- Take narcotic medication only as needed.
- Ice every 20 minutes out of every hour to ease the pain.
- No sex, masturbation, or lifting things more than 25 pounds for one week.
- You may shower the day after surgery, but no baths for a week.