Laparoscopic Varicocelectomy

February 17, 2020

Varicocelectomy is surgery to repair a varicocele. A varicocele is swelling of veins in the scrotum. A varicocele can cause pain or a heavy feeling in the scrotum but is usually painless. It can also cause problems with fertility. During the surgery, the swollen veins are cut and the ends are closed off. Other veins in the groin area then take over carrying the blood supply. The surgery may be done with a method called laparoscopy or through open surgery. During laparoscopy, a thin, lighted tube or scope (called a laparoscope) is used. The scope allows the doctor to work through a few small incisions.

The day of surgery

This surgery takes around 1 hours. You’ll likely go home the same day.

Before the surgery begins:

• An IV (intravenous) line is put into a vein in your arm or hand. This supplies fluids and medicine (such as antibiotics).
• To keep you pain-free during the surgery, you’re given general anesthesia. This medicine puts you into a deep sleep like state through the surgery.
• A thin tube (catheter) is placed in your bladder to drain urine.

During the surgery:

• The doctor makes a few small incisions in the belly (abdomen).
• The scope is placed through one of the incisions. It sends live pictures of the inside of the abdomen to a video screen. 
• The abdomen is filled with gas. This makes space for the doctor to see and work.
• Using tools placed through the other incisions, the swollen veins are cut. The ends may be sealed with tiny clips. Or the ends may be cauterized.
• When the surgery is complete, all tools are removed. The incisions are closed with stitches glue or staples.

After the surgery

You’ll be taken to a recovery room to rest until the anesthesia wears off. You may feel sleepy and nauseated. If a breathing tube was used, your throat might be sore at first. You’ll be given medicines to manage any pain.

Recovering at home

Follow all the instructions you’ve been given. Make sure to:

• Take all medicines as directed.
• Care for your incisions as instructed.
• Apply ice or a cold compress to the scrotum for 10 minutes at a time for the first 48 hours. This helps reduce swelling.
• Follow your doctor’s guidelines for showering. Avoid swimming, bathing, using a hot tub, and other activities that cause the incision to be covered with water until your doctor says it’s OK.
• Not have sex for 1 to 2 weeks.
• Not do any heavy lifting and other strenuous activities as directed.
• Not drive until your doctor says it’s OK.
• Not strain to pass stool. If needed, take stool softeners as directed by your doctor.

Follow-up care

You’ll have follow-up visits so your doctor can check how well you’re healing. If your stitches or staples need to be removed, this will likely be done in 7 days. If you’re concerned about your fertility, a sample of your semen can be checked in about 3 to 4 months. This helps see if the number and quality of your sperm have improved.

Risks and complications

Risks and possible complications include:

• Infection
• Bleeding, blood clots
• Return of the varicocele
• Failure to restore fertility
• Fluid around a testicle (hydrocele)
• Shrinking (atrophy) of a testicle
• Damage to nearby nerves, blood vessels, or organs (including the intestine)
• Short-term (temporary) decrease in sperm count
• Chronic pain