Varicoceles are a relatively common condition that tends to occur in young men, usually during the second or third decade of life. These varicoceles may cause no symptoms and are harmless. But sometimes a varicocele causes pain or atrophy (shrinkage), or fertility problems.
Normally, blood flows to the testicles through an artery, and flows out via a network of tiny veins that drain into a long vein that goes up through the abdomen. The direction of blood flow in this vein should always be up, toward the heart. A series of one-way valves in the vein prevent the reverse flow of blood back to the testicles.
These one-way valves sometimes fail. The reverse flow of blood stretches and enlarges the tiny veins around the testicle to cause a varicocele, a tangled network of blood vessels, or varicose veins.
Varicoceles repair methods include:
Open surgery: This most common form of treatment usually is done on an outpatient basis, using general anesthetic or local anesthetic. Most commonly, your surgeon will approach the vein through your groin (transinguinal), but it's also possible to make an incision in your abdomen or below your groin.
You may be able to return to normal, nonstrenous activities after two days. You may return to more strenuous activity, such as exercising, after two weeks.
Pain from this surgery generally is mild. Your doctor may prescribe pain medication for the first two days after surgery. After that, your doctor may advise you to take over-the-counter (OTC) painkillers, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) to relieve discomfort.
Your doctor may advise you not to have sexual intercourse for one week. It takes about 72 days for sperm to generate, so you'll have to wait three or four months after surgery to get a semen analysis to determine whether the varicocele repair was successful in restoring your fertility.
Laparoscopic surgery: In this method, your surgeon makes a small incision in your abdomen and passes a tiny instrument through the incision to see and to repair the varicocele. However, this procedure, which requires general anesthetic, is not a commonly used one because it poses more risk while offering little advantage.
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