Thursday, May 21, 2009

Varicoceles FAQs: part 6

What are surgical options for treatment of a varicocele?

There are three options to treat a varicocele and include
- Open surgical varicocele repair
- angiographic embolization- highly recommended
- laparoscopic method

What are results after surgery?

Surgery is hyped up to be the best treatment for Varicocele. It is estimated that in about 40-60 percent of men, sterility can be restored. However, real data are lacking and many men have undergone this surgery, needlessly. There are many men who have had their Varicocele fixed and still cannot conceive.

Do Varicocele recur after treatment?

Sure, recurrence of Varicocele is quite common. These recurrences may occur a few months or may even occur a few years later. In most cases, recurrence is due to poor technical surgery and leaving some small veins intact at first surgery. To obliterate a Varicocele; one has to ligate all small veins.

Who fixes a varicocele?

Urologists are physicians who specialize in the field of male genitals and most are decent surgeons.

What is embolization?

This is perhaps the best treatment for Varicocele. It is an easy procedure done by an interventional radiologist. One side of your groin is numbed with a local anesthetic and a small tube is passed into the vein. Using x rays, the Varicocele is identified in the scrotum and through the tube, glue like substances are injected into the Varicocele. Confirmation that the Varicocele is blocked is done with another x ray study and you are done. There is no general anesthesia, no incisions and the pain is minimal. You go home in the evening. Data on embolization are decent and recurrences are rare. However, the procedure is very expensive and there is still a question of whether the Varicocele should be treated in the first place.

Final Advice

There is a lot of conflicting advice on Varicoceles and how they may affect sterility. Surgery for Varicocele is strictly elective and no one should be rushed into. For best advice, talk to a reputable urologist. Ask questions and if in doubt seek a second opinion. Whilst there are some who say Varicocele affect sterility, there are is also data that show that Varicoceles have no bearing on sterility. The last thing you want is to undergo an unnecessary surgical procedure that has a real risk of damaging your sexual organ. If you have no symptoms- leave the Varicocele alone. If you have symptoms, wear scrotal support panties. Both are reasonable treatments.

One should only undergo Varicocele surgery if there is documentation of abnormal sperm and that one is unable to father a child.

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