Have you heard of varicose veins? Varicoceles are similar. But they form around the testicular region rather than an individual's legs. While this problem may not lead to a severe issue, it can affect fertility in men.
It occurs due to the enlargement of some veins in the scrotal region, as some valves malfunction in blood circulation. The condition can impact males ranging between the ages of 15 and 25. To treat this condition, individuals opt for varicocelectomy surgery.
Varicocelectomy is a surgery that aims to remove varicoceles. These veins swell when the blood fails to return to the heart. Then it fills up the scrotum. Their large size can accumulate blood in the scrotum or cause a backflow. You can see varicoceles through the skin.
These are commonly present in ten men out of 100. Having varicoceles does not lead to complex issues, but it may cause complications. These include discomfort or pain in the testicles, scrotum feeling heavy, male infertility, and problems in testosterone production. This condition can lead to a reduction in the total sperm count.
Varicocelectomy surgery helps with this condition by restoring adequate blood circulation to your sex organs.
The doctor you visit will start the diagnosis by asking about your symptoms. Besides that, the professional will examine your testis. This will involve you sitting down, standing up, taking a pooping position, or performing the Valsalva maneuver.
Varicoceles occur in the left testis, called unilateral varicoceles. Nonetheless, some individuals also suffer from bilateral varicoceles or both affected testes. To confirm the diagnosis, the doctor will order a blood test, a semen analysis, and an ultrasound.
While blood tests and semen analysis help check if the condition affects fertility in males, ultrasound offers a clear picture of the veins in the scrotum. Varicocele has four grades, which include:
Depending on how intrusive the varicocele operation is and the tools used, there are different types of surgeries. These include open varicocelectomy and minimally invasive procedures.
The open surgery involves the surgeon cutting the tissues and skin of the patient. It helps the surgeon have a precise idea about the concerned region. These areas include the lower abdomen, groin, and scrotum.
They do this to locate and fasten off the varicose vessels. These comprise three approaches, including inguinal, retroperitoneal, and subinguinal ligation, explained in the next section.
Many individuals also choose a minimally invasive procedure for the least intrusive and minor skin and tissue damage. These involve techniques to minimize surgical impact, like cuts. This type of varicocele operation also has further divisions, including laparoscopic and microsurgical.
Open varicocelectomy, also called open surgery, includes large openings or cuts on the tissue or skin to enable the surgeon to access the internally affected region without a camera. The surgeon conducts the surgery under general or local anesthesia and will access the area via the groin, upper thigh, or abdomen. The approaches differ based on the incision's position. These include:
The practitioner makes an incision in the lower abdomen. They will reach the varicocele from the posterior of the peritoneum, a watery and transparent membrane lining the abdomen.
The healthcare professional will approach the varicocele via the inguinal canal. The groin comprises the inguinal canal, which occurs close to your abdomen and stomach's lower region.
Like inguinal ligation, the incision will occur in the groin region to enable the surgeon to access the affected area with enlarged veins in your scrotum. Also known as the Poupart's ligament, the groin ligament is under the inguinal ligament.
The surgeons benefit from surgical microscopes and ultrasound to seal problematic veins and divert the blood flow through healthier vessels. During your varicocele surgery recovery time, you may feel minimal pain, which is natural. After some rest, you can soon return to your daily activities.
Minimally invasive surgery for varicocelectomy covers two procedures:
Varicocele microsurgery incorporates a microscope to locate the correct veins causing the problem. The process helps in seamlessly determining the affected veins from the healthier ones.
The approach involves the surgeon making an approximately 1 cm cut in the groin's upper area or over the scrotum. Next, they will use tiny instruments to seal the delicate veins and eliminate the varicoceles. The procedure lasts about two to three hours, and you can return home that day.
Besides varicocele microsurgery, you have the laparoscopic option, which includes especially tiny incisions or openings in the lower abdomen. The surgeon will use a narrow tube with an attached camera called the laparoscope and insert it through the cuts to locate and view the varicocele via the computer screen.
The surgeons use precise and undersized instruments to treat the affected veins and tie them off. The entire surgery takes up to 40 minutes and allows the patient to leave for home the same day. The laparoscopic varicocelectomy recovery time ranges from two to four weeks. Some individuals can visit work after three to five days.
Some advantages of choosing from various types of varicocelectomy procedures are as follows:
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To prepare for the varicocelectomy, the healthcare professional will note down your vital and conduct a health evaluation. If you consume any OTC medications and supplements, notify your surgeon. To alleviate the hazard of bleeding, refrain from using blood thinners, some herbal supplements, anti-inflammatory drugs, and aspirin days before the operation.
The healthcare professional may also instruct you to avoid drinking fluids or eating food eight to twelve hours ahead of the varicocelectomy. Following these directions is mandatory, as you may puke under anesthesia with food and fluids in your system. It can lead to inhaling fluids or food into the lungs, which can cause asphyxiation or pneumonia.
Moreover, prepare transportation before the surgery, as you cannot drive home post-operation.
Varicocelectomy procedures involve a urologist, nurses, and an anesthesiologist. The process starts with sedating the patient. Then, the surgeon will make the required opening in the skin to find the varicocele. They will cut and tie the ends of the vein to redirect the blood flow.
The urologist may utilize mini silicone tubes to drain the fluid or blood and close the tubes right. Next, they will close the incisions via stitches. Once completed, the patients can prepare for the after-varicocele surgery recovery stage.
The healthcare professional will bandage the stitches after the procedure. They will monitor your health once the effects of anesthesia wear off. The after effects of varicocele surgery involve feeling dazed and sore in the abdominal region or groin. You can go home after a few hours of the procedure.
When considering open surgery or laparoscopic varicocelectomy recovery time, it may differ from one person to another. The wound and swelling may heal in at least four weeks, with tenderness lasting about six weeks.
You must follow your doctor's instructions for taking care of the surgery site, such as ice packing, cleaning concerned areas to avoid infection, taking showers, not baths, avoiding swimming, etc.
After varicocele surgery recovery, people can go back to work or school. Most individuals can return to their regular lives in three days.
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