Varicocele is the enlargement and varicose formation of the veins surrounding the testes. It is one of the most common urological conditions in men and is a major cause of male infertility. Varicocele increases abnormal heat in the testes, which can reduce sperm count, motility, and quality, and may also lower testosterone levels. The most effective treatment for a definitive cure is microsurgical varicocelectomy.
What Are the Symptoms of Varicocele?
- Pain or a feeling of fullness in the scrotum (testicular sac)
- Testicular pain that increases after prolonged standing
- Shrinking or softening of the testes
- Low sperm parameters detected during infertility evaluations
- Symptoms related to low testosterone (reduced sexual desire and erectile dysfunction)
What Is Microsurgical Varicocelectomy?
Microsurgical varicocelectomy is a urological surgery performed under a specialized surgical microscope with high magnification. In this procedure, each varicose vein is carefully ligated. Testicular arteries, lymphatic vessels, and the spermatic cord are preserved. Using a microscope minimizes the risk of complications and increases the success rate.
How Is Varicocele Surgery Performed?
- Usually performed under spinal anesthesia (numbness from the waist down)
- A small incision is made in the groin area
- All anatomical structures of the testes are visualized under the microscope. The dilated veins causing varicocele are identified and ligated
- The surgery takes about 1 hour for a single-sided case and approximately 1.5 hours for bilateral cases
- Patients are usually discharged on the same day
Advantages of Microsurgical Varicocele Surgery
- Provides the lowest recurrence rate
- Improves sperm count, motility, and quality
- Enhances testosterone production in the affected testis
- Reduces pain complaints
- Small incision offers an aesthetic advantage
Recovery After Microsurgical Varicocele Surgery
- Mild scrotal pain may occur during the first days and usually resolves quickly
- Daily activities can be resumed within 1–2 days
- Sports and heavy exercise can typically be resumed after 3–4 weeks
- Improvements in sperm parameters are usually observed within 6–9 months
Final Notes
Microsurgical varicocelectomy is the gold standard treatment for varicocele. When performed by experienced urologists, it provides significant improvements in both sperm quality and testosterone levels.
