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Testicular varicocele surgery

Testicular varicocele surgery is an intervention to relieve the stagnation of the testicles, which can be used to relieve the increase in venous pressure that is responsible for the development of the lesion.

Surgery can be performed with open or laparoscopic intervention.

What is varicocele?

Varicocele, or varicose vein dilatation, is the enlargement of the bundle of vessels that drain from the testis.

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How does testicular varicose vein dilatation develop?

The development of varicocele or testicular varicose veins can be explained by anatomical causes.

The blood (venous blood) leaving the testicles is lead both sides by the testicular vein (vena testicularis). On the right side, this vein connects to the main vein of the body (vena cava inferior) at an acute angle, while on the left side, to the renal vein (vena renalis) at right angle. As a result, the left testicular vein tends to dilate due to increased abdominal pressure (intense sports, physical work) or simply due to gravity, and collateral veins may also form on this side, increasing varicose veins.

How can testicular varicose veins be diagnosed?

Varicocele is detected after physical examination by testicular doppler (flow) ultrasound.

Already during the physical examination, curvy, wide varicose veins appear in the upper part of the scrotum. During the ultrasound examination, the width of the blood vessels is examined at rest and then during a strong abdominal press.

The diagnosis of varicocele requires one or more varicose veins larger than 4 mm and showing increased flow.

When is testicular varicose vein surgery needed?

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.

How is laparoscopic testicular varicose vein surgery performed?

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.

How is microsurgical testicular varicose vein surgery performed?

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.

What are the advantages of varicocele surgery?

  • Effective, causal treatment of the disease
  • Elimination of complaints

Additional advantages of microsurgical testicular varicose vein surgery

  • Significantly lower chance of recurrence (5-8%)
  • Milder pain
  • Minor bleeding
  • The patient regains his ability to work sooner after the operation and can return to his daily activities more quickly

What are the risks of the surgery?

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.

How do I prepare for surgery?

The surgery does not require special preparation. If your doctor has prescribed medicines before the procedure, take them at the specified time.

What to do after testicular varicose vein surgery?

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.

Convenience services

We accommodate our clients in a modern, pleasant, air-conditioned single room. Each room has a private bathroom, fridge and TV, as well as free WIFI access. We also provide our clients with individual nurse supervision, who will help your continuous recovery during your stay.

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