Varicoceles and Infertility in Men

Varicoceles are enlarged varicose veins that occur in the scrotum. It is very much common in men affecting overall of 40 out of 100 men with known infertility. Varicoceles occur most often in the left testicles.  Varicoceles repair is done to improve the infertility condition in male. It can be done surgically on patients using local or general anesthesia.

A small incision is made in the abdomen close to the testicles originally descended through the abdominal wall. The vein that produces the varicocele are identified inside the body, and cut to eliminate blood flow.

There is also a nonsurgical procedure called percutaneous embolization that is done to correct the problem. a small catheter is inserted through large vein in the groin and advanced to varicocele, which is blocked off by a balloon, coil or medicine.

After the surgery you can expect to o home within 4 hours. Pain medicine is prescribed by the doctor for few days after surgery. You can resume light work duties after 1 to 2 days of surgery and other heavy activities can be done within week’s time.

What is the need of surgery?

Vericoceles are thought that it raises temperature of the testicles or cause blood to back up in vein supplying to testicles. However the way the mechanism by which it affects the fertility is poorly understood, but it is the fact that that varicoceles helps in damaging and killing the sperm which in return causes infertility in male. So there are repairs that are necessary to improve the fertility of male who have both the problems varicoceles and impaired sperms.

Some researchers observed that after the repair is being made it produces favorable pregnancy rates but others say that the rates are same and the repair does not affect the fertility. However there is a strong evidence to suggest that repairing a varicocele improves testicular function and may prevent any further testicular damage over time, but we should not forget that this correlates closely with the size of the varococele.  Thus testicular function should be accessed directly by semen analysis, measurement of testis volume and blood test.  If there is a evidence of the damage to the testicles, the repair might be important to improve testicular function and also prevent further decline.

It is important to have an individualized approach to varicocele management. The decision to treat it is made based on size, patient’s fertility goal, and symptoms of low level of testosterone or scrotal discomfort and blood test.