Testicular varicocele surgery

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.

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.

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

• 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

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.