Everything you need to know about varicocele and varicocelectomy in Iran

Varicocele and Varicocelectomy

A varicocelectomy is a surgery to remove varicocele and restore proper blood flow to reproductive organs. A varicocele is an enlarged swollen veins collection in the scrotum. Varicoceles can hinder the testes drainage and lead to infertility in men, as it affects semen production. varicocelectomy can be treated by multiple methods including open surgery.

How varicocele affects the scrotum?

When a varicocele develops in the patient’s scrotum, it blocks blood flow to the rest of the reproductive organ. The Scrotum is a bag that comprises the testicles. Varicocele hinders the blood revert to the heart through these veins. As a result, the blood pools in your scrotum veins and causes them get large abnormally. This may lead to your sperm count reduction.

Varicoceles usually occur on the left side of the patient’s scrotum and those that appear on the right sides are more likely to be caused by tumors or growth. Thus, if you suffer from varicocele on the right side of your scrotum, your doctor may recommend a varicocelectomy.

Varicoceles may lead to infertility. Thus, if you want to have a child but you have a conceiving problem, your doctor may recommend varicocelectomy.

Types of varicocele surgery or varicocelectomy

1. Open surgery varicocelectomy

This outpatient operation is done under local or general anesthesia and is the most invasive approach.  Commonly, the surgeon approaches the vein through different areas. He can make an incision in the lower abdomen (preperitoneal) or make it in the groin (inguinal ligation or sub inguinal ligation).

The surgeon uses a surgical microscope. It enables him to see the area better during the varicocelectomy. He also uses a Doppler ultrasound that helps guide the procedure. Using the tools, the surgeon closes the affected veins and reroutes the blood through other, healthier vessels.

These advances in varicocele repair results in less post-surgical complications.

2. Laparoscopic varicocelectomy

In this type of varicocelectomy, the surgeon makes 3 incisions in the abdomen and inserts the laparoscope through one of the incisions to magnify the area and see the varicocele. He inserts other surgical tools through other incisions. The surgeon can sever the swollen veins from the healthy ones. He may tie off the veins that direct blood into enlarged varicocele so that it will finally disappear.  He seals off the vein ends with small clamps. He can also do it by cauterizing the veins with heat. In the end, the laparoscope and other tools are removed.

The procedure is done under general anesthesia. It is very similar to open surgery but is less invasive than it.

3. Percutaneous embolization varicocelectomy

This outpatient procedure is done under local anesthesia. This method provides the least invasive varicocelectomy. The doctor inserts a tube into a vein in the groin. He passes a catheter through the tube and views the enlarged veins on the monitor by a camera that is attached to the catheter. He releases coils or solution that makes scarring to create a blockage in the testicular veins and repair the varicocele.

The relatively noninvasive nature and preservation of the testicular artery are the advantages of percutaneous embolization