The treatment of varicocele is possible surgically. Based on professional recommendations, the primary recommended methods are open microsurgical varicocelectomy and laparoscopic varicocelectomy. Both types of surgery are currently available in our hospital.
Based on the latest literary data, the possibility of recurrence is the lowest in the case of the microsurgical method (about 5-8%).
Failure to perform surgery is not life-threatening. However, the high degree of testicular varicose veins detected before puberty can have a harmful effect on testicular function later on, therefore surgery is definitely recommended at this age.
This urological procedure can only be performed under anaesthesia.
During the laparoscopic procedure, a 1.5 cm incision is made under the navel, and the abdominal cavity is inflated with carbon dioxide through a special puncture needle.
Then we look at the lesion in the abdominal cavity and insert 2 pc of 5mm auxiliary trocars. One above the pubic bone in the middle and one on the left, lower abdomen. The left testicular varicose vein is located under the peritoneum, which is looked for and lifted, and then plastic clips are placed on it to close the vessel or vessels.
At the end of the surgery, carbon dioxide is released from the abdominal cavity and the skin wounds are closed with absorbent suture.
Microsurgical varicocelectomy is performed under general anaesthesia.
Below the left outer groin ring, approx. a 2-3 cm skin incision is made. We look for the spermatic cord, which is lifted to the level of the skin. The surgery is then performed under a special high-magnification operating microscope.
Thanks to the magnification, the varicose veins can be easily separated from the lymphatic vessels, the artery can be easily found, and even the smallest, not yet dilated varicose veins can be recognized. The latter is important for recurrence, as later these varicose veins can turn into varicocele again.
During the operation, the varicose veins are tied down and cut. The surgical wound is closed with an absorbable suture.
The frequency of complications is negligible compared to the number of surgeries performed.
General dangers of medical intervention, such as infections, post-bleeding, wound healing, etc. may occur in the case of this intervention. The chances of developing complications are significantly influenced by what previous abdominal surgeries have taken place and whether there is intestinal adhesion in the abdominal cavity, which may make surgery impossible.
In the case of laparoscopic surgeries, there is always the possibility of open abdominal surgery, i.e. the surgery needs to be converted. This happens only when an unexpected event occurring during surgery is impossible to control with laparoscopic devices. Other comorbidities of the patient (e.g. cancer, hypertension, obesity, diabetes, haemophilia, diseases of the haematopoietic system) can greatly contribute to the development of surgical complications.
The surgery does not require special preparation. If your doctor has prescribed medicines before the procedure, take them at the specified time.
After the procedure, mild pain may occur on the affected surgical area, which in some cases may be accompanied by mild swelling and bruising of the scrotum.
A specific feature of laparoscopic intervention can be left shoulder pain, which is mild and resolves on its own in a few hours. The dressing covering the surgical wounds should initially be protected from moisture. Medication should be used as directed by the doctor to prevent infections and reduce pain.
It is possible for the patient to leave the hospital the day after surgery. Your doctor will inform you about further treatment options.