What Are the Side Effects of Varicocele Surgery?Fertility Treatment
Testicular varicocele is one of the common diseases among men, in which the veins in the scrotum expand and twist abnormally. As you already know, veins transport blood from different organs to the heart and vice versa. Therefore, if one of the testicle’s vessels is damaged, blood circulation in the reproductive system is disturbed. As a result, the blood accumulates in the scrotum and causes testes enlargement and pain. By having varicocele surgery, the whole reproductive system returns to its normal state, and the pain will be gone.
If an experienced urologist performs varicocelectomy, its risks and complications will be minimal. Some of the most common side effects of this operation include hydrocele, testicular atrophy, moderate pain, wound infection, and scrotum tenderness.
What Is Varicocele and What Are Its Complications?
As mentioned earlier, the blockage and abnormal enlargement of testicular veins is called varicocele. Varicocele can impair a male’s reproductive system and reduce the quantity and quality of his sperm by increasing the temperature in his testicles. Therefore, if not treated, it can indirectly affect male infertility. Usually, varicocele occurs on the left testicle, but in about %10 to 15% of cases, it happens to both testicles.
Based on its severity, varicocele can be divided into the following three categories:
- Grade 1 (Mild): the testicular veins are slightly dilated and can be easily palpated.
- Grade 2 (Moderate): the veins are dilated and can be felt while standing.
- Grade 3 (Severe): the veins are extremely dilated and can be seen with the naked eye. Grade 3 varicocele is associated with chronic pain in the testicles.
Varicocele Surgery Complication
As mentioned above, if a skilled urologist performs varicocele surgery, it will have minimal side effects. The varicocelectomy side effects are either short-term or long-term. Short-term complications, such as bruising, bleeding, foul-smelling discharges coming out of the wound, and mild infection, are common and will be resolved on their own within a couple of days. The long-term complications, however, will remain a bit longer and may require medical intervention. In the following, you can see some of the long-term complications of varicocele surgery.
- Damage to the scrotum’s veins
- Complications of anesthesia
- Chronic pain in testicles and groin
- Testicular atrophy
- Swelling of the testicles
Read on to get detailed information about each of these complications.
Not getting enough rest and standing or walking too much after varicocele surgery can cause hydrocele. Also, if the doctor does not separate the lymph tissue properly, the abdominal fluid will accumulate around the testicle and cause hydrocele. Abnormal enlargement of the testicle after the operation is the main sign of hydrocele. Fortunately, hydrocele is not painful and doesn’t affect fertility, but it makes the testicles heavy and swollen.
Damage to the scrotum’s veins
Damage to the scrotum’s veins is another complication of varicocele surgery. Arteries and veins in the body are very close to each other, so there is a small chance of damaging healthy veins during varicocelectomy, especially in open surgery. The chance of damaging the scrotum’s veins in open varicocelectomy is between 12 and 24%, while it is about 1% in other surgical methods such as laparoscopy.
Complications of anesthesia
Laparoscopic varicocelectomy is mostly done under general anesthesia. Open surgery and microsurgery methods will also be performed either under general anesthesia or the local one. The anesthetics surely have some inevitable side effects, such as dizziness, headache, and nausea, which will disappear in a few days.
Chronic pain in testicles and groin
During the varicocelectomy, the surgeon cuts and seals the damaged veins in your scrotum, So you will feel mild to moderate pain under your abdomen and on your left testicle for a few days. You can take prescribed painkillers to manage the pain, but if it resumes for more than five days, contact your doctor.
During varicocelectomy, some healthy veins may also be cut by the surgeon. This issue will reduce the blood supply to the testicles and, as a result, will lead to testicular atrophy over time. If testicular atrophy is left untreated, it will be permanent.
Swelling of the testicles
Another complication of varicocele surgery is testicle’ swelling, which can be seen with bare eyes. Swelling for a few days after the operation is normal, and there is nothing to worry about, but if it is not subsiding gradually, you must seek medical help.
Types of Varicocele Surgery
Four types of varicocelectomy are practiced to remove the damaged veins in the scrotum:
Open or standard surgery
In this method, the surgeon makes a two-centimeter incision in the scrotum, takes out the spermatic cord, removes the varicocele vein, and seals the enlarged vein with surgical glue, electrical current, laser beam, etc.
The surgeon uses a microscope to find damaged and healthy veins in this technique. To remove the varicocele vein(s), the doctor makes a one-centimeter incision above the scrotum, inserts the high-powered operating microscope into the damaged vein, seals the artery, and stitches the incision.
Laparoscopic varicocelectomy is the most precise technique of removing enlarged veins which only takes 10 to 15 minutes. In this operation, the damaged veins are marked by a surgical telescope, and then they are cauterized, clipped, or tied.
Percutaneous embolization is also a minimally invasive method in which the surgeon makes an incision in the groin, inserts a narrow tube into the body, and moves it toward the testicular veins. When the tube enters the defective veins, it closes them via small metal coils or chemicals and redirects the blood flow toward the healthy veins.
The Best Type of Varicocele Surgery
According to recent studies, the best type of varicocele surgery is laparoscopic varicocelectomy. In this method, the damaged veins and lymphatic tissues are accurately detected by a laparoscopic lens; therefore, the risk of damage to the arteries, hydrocele, and testicular atrophy is almost zero. Not only does this surgery have a higher chance of success, but it also has the least complications and shortest recovery period.
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Varicocele Surgery Aftercare
After varicocele surgery, you probably feel pain in your groin and lower abdomen for three to six weeks. Also, your scrotum and groin can be bruised and swollen for two to four weeks. If you undergo minimally invasive surgeries, you can return to work and your daily routine within a few days.
It should be noted that the recovery period of varicocele surgery may take two days to two weeks. During this period, the following points should be considered:
- Avoid sexual activities for four weeks
- Stay hydrated
- Have low-fat foods such as chicken breast, plain rice, and yogurt
- Take your prescribed medications fully and on time
- Use ice packs to reduce swelling
- Have fiber-rich foods to prevent constipation
- Avoid heavy sports, swimming, and other water sports
- Avoid smoking and drinking alcoholic beverages
If you don’t have discharge, you can take a bath 3 days after the varicocele surgery. If you have a high fever, excessive discharge, bleeding, or severe swelling in the testicle area, inform your doctor.
Varicocele Surgery in Iran
In Iran, new and precise methods of varicocelectomy, like laparoscopy and microsurgery, are done by experienced surgeons and urologists. You can benefit from advanced technologies and high-quality clinics in Iran at an affordable price. In fact, the cost of varicocele surgery in Iran starts from $1,300 and may soar to $4,500, while the same operation will cost you around $5.500 in the USA, £3500 in the UK, and $2,500 and $4,000 in Australia.
Varicocele surgery aims at removing or sealing the enlarged veins in the scrotum to increase the patient’s fertility rate and reduce his pain. Four types of varicocelectomy are practiced today: open surgery, microsurgery, laparoscopy, and percutaneous embolization, each of which has its own pros and cons. This operation has both short-term and long-term side effects, such as swelling, infection, hydrocele, testicular atrophy, etc. Some of these complications can be prevented or reduced by having a healthy lifestyle, getting enough rest, taking prescribed medicines as instructed, and avoiding activities that increase blood pressure.