What You Need to Know About Microsurgical Varicocele Surgery

It is known that varicocele affects 40% of infertile men. When varicocele progresses, the veins become prominent in the affected testis or testes (usually the left-sided testis is affected). For the definitive diagnosis of varicocele disease, which can be diagnosed by physical examination in the advanced stage, Scrotal Color Doppler Ultrasonography must be performed.

Who Should Have Varicocele Surgery?

Patients who:

• Want to have children and have detected abnormalities in sperm parameters,

• Experience complaints due to a decrease in testosterone (male hormone) levels,

• Have reduced life comfort due to pain in the groin, testis, or testes, are accepted as suitable candidates for varicocele surgery.

Why is Varicocele Surgery Performed?

The main purpose of varicocele surgery is to close (ligate) the veins whose function is impaired due to varicose dilation; to stop the flow of deoxygenated blood (dirty blood) to the testes, to prevent harmful agents from reaching them, and to ensure that testicular temperature returns to ideal levels. By returning the testes to their ideal temperature, healthier sperm can be produced, and at the same time, testosterone production can return to normal. Thus, a significant increase in sperm values is experienced.

Which Method is Used for Varicocele Surgery?

"Microsurgical Varicocele Surgery" (Microsurgical Varicocelectomy) is accepted as the gold standard method for the treatment of varicocele disease. With microsurgical varicocelectomy, it is possible to close both the veins that have become varicose and those that have the potential to become varicose in the future. Thus, the probability of varicocele recurrence can be minimized.

What is Microsurgical Varicocele Surgery? > Note: Microsurgical varicocelectomy must only be performed by experienced surgeons!

The surgery, which is usually performed under spinal anesthesia, is completed in approximately 45 minutes. In this process, even the thinnest veins can be viewed under a high-powered microscope, and in addition to varicose veins, veins that are likely to become varicose in future years can be closed with the help of micro-clips. Since micro-arteries (testicular arteries) providing clean blood flow to the testes and lymphatic vessels can be preserved during microsurgical varicocele surgery, patients do not experience any complications (such as hydrocele or atrophy) after surgery.

Advantages of Varicocele Surgery Under Microscope

• Getting rid of varicocele disease with a single surgery.

• Almost no probability of recurrence since veins likely to become varicose in the future are also intervened.

• Preservation of arteries and lymphatic channels while ligating veins.

• Faster recovery in sperm values compared to traditional open (macroscopic) varicocele surgery.

After Microsurgical Varicocele Surgery

• After microsurgical varicocele surgery, the patient stays in the hospital for 1 day and is discharged the next day.

• It is recommended to protect the testes as much as possible for a few days; movements affecting the area such as sudden sitting and standing should be avoided.

• Antibiotics and painkillers must be used after the operation. Detailed information on this subject is conveyed to patients.

• Vitamin supplements must be started immediately to increase sperm parameters after surgery.

• Bathing is allowed on the 2nd day after surgery.

• Those who have had microsurgical varicocele surgery can return to work a few days after the operation. Patients may need to rest for 7 – 10 days only if they work in a job that requires standing for a long time and expends physical effort.

• Patients should go for a follow-up examination 1 week after the operation.

• Sexual intercourse prohibition usually depends on the patient's recovery process and the doctor's evaluation.

• Sperm parameters are checked every 3 months after the operation.

Does Male Infertility Improve After Microsurgical Varicocelectomy?

The main purpose of microsurgical varicocele surgery is to reverse the decline in sperm values due to varicocele disease and to keep sperm values at normal levels. It is not a correct approach to state that one can definitely have children naturally after varicocele surgery. However, since sperm quality increases with varicocele surgery, it can be easily said that the person's chance of having children increases both naturally and with Assisted Reproductive Technologies (ART) such as IVF.

> Note: For a baby to be conceived after varicocele surgery, both spouses must not have a different ailment that would prevent pregnancy. Therefore, it is recommended that health screenings of couples who want to have children be performed simultaneously by both urology/andrology and obstetrics/gynecology specialists!

The success of microsurgical varicocelectomy is also related to factors such as patients eating healthily after the operation, adopting an active lifestyle (exercising), and especially staying away from smoking. When people who want to have children do not neglect the use of vitamin supplements, ensure weight control, and stay away from oxidative substances such as cigarettes and alcohol in the post-operative period, the desired increase in sperm values can be achieved.