Varicocele Repair.
What is a Varicocele?
A varicocele is an enlargement of veins in the scrotum. These veins bring blood away from the testicles. They occur in 20% of all men and in 40% of men who are having difficulty with fertility.
The problem arises from veins don’t work properly resulting in blood pooling around the testicle. The increase in heat then decreases the function of the testicle resulting in pain, poor growth and/or sub-optimal hormone and sperm production.
Varicocele severity ranges from Grade 1-3 with Grade 3 being the most likely to effect function. Those varicoceles are typically visible from across the room.
The Surgery.
Varicocele repair is a quick and minimally invasive surgery that is best accomplished through a microsurgical approach.
One of the very few providers in the Midwest offering this approach, Dr. Kovac is the most experienced with >150 cases per year being performed.
Dr. Kovac performs the surgery through a small, less than 2 cm incision using a surgical microscope for optimum visualization. Typically lasting an hour, the surgery should improve both hormone and sperm production with minimal pain, fast recovery and a quick return to work.
Surgery Details.
Complications can occur in <0.5% of cases and include bleeding, hematoma, infection, recurrence, chronic pain, testicular atrophy, testicular loss and failure to improve testicular hormone and sperm production.
Other surgical approaches such as the open and laparoscopic approach are inferior and therefore not recommended. Embolization is typically suggested in cases of recurrence.
Typically patients will be sent home with a few narcotic pills that help with pain control. No antibiotics are needed.
The incision is closed with absorbable stitches and covered in skin glue that comes off after a few weeks.
Post operative.
Following surgery, you will recover for approximately 40 minutes under excellent nursing care.
Once you arrive at home, rest and do not consume any heavy meals for the rest of the day.
You will NOT be able to drive on the day of, and after surgery, as well as when using narcotics.
A shower is allowed on the day after your procedure. No swimming or hot tubs for 2 weeks.
Immediately after the surgery, you may experience bruising around the incision and around the penis. Veins along the side of the penis can also become hard. This will NOT affect your erectile function. Sexual relations can be resumed, gently, after 1 week.
For 6-9 months, the incision will be hard directly underneath and the veins in the scrotum can be felt to be hard and lumpy. This is normal. A recurrence can only be assessed by an ultrasound.
Examples of typical sub-inguinal microsurgical varicocele incisions
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Varicocele Incision - Before Closing (cm)
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Varicocele Incision - After Closing (cm)
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Varicocele Incision - Skin Glue
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Varicocele Incision - Before Closing (cm)
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Varicocele Incision - After Closing (cm)
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Varicocele Incision - Skin Glue
