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Microsurgical Varicocele Repair

What is a Microsurgical Varicocele Repair?

A group of blood vessels known as the pampiniform plexus provide drainage from the testicles.  When they fail to drain efficiently, they can become swollen, forming the equivalent of varicose veins in the scrotum.  Varicoceles are not uncommon in the general population (about 15% of men have varicoceles), but they are especially common (40%) in men presenting with fertility problems.  Varicoceles range in size from I (smallest) to III (largest).  To your physician, a grade III varicocele will feel like a bag of worms while you stand during your physical exam.

It is hypothesized that the swollen veins of a varicocele can increase the temperature of the scrotum, leading to a decrease in sperm production.  While the actual pathophysiologic mechanism is unknown, 40-70% of men undergoing a varicocele repair show an increase in sperm quality, and 40% are able to initiate pregnancy.

Surgical reparation of the vein involves making a small incision in the groin area.  From here, using a microscope, your surgeon will locate the vein leading to the varicocele and cut off the flow of blood.  The incision will be closed with a few small sutures.

Where is the surgery performed?

The microsurgical varicocele repair is performed at Mount Sinai Hospital.

Will I be asleep?

Yes, general anesthesia is used.

How do I prepare for the surgery?

You should not take anything containing aspirin 1 week prior to your surgery.  You will be contacted 48 hours prior to the procedure to confirm the date and time of the procedure.  Do not eat or drink anything 8 hours prior to your scheduled surgery time - this includes water.  If there are medications you must take, you may do so with minimal water.

When can I return to work?

We suggest that you allow 48 hours for recovery.

How long must I wait before I can return to normal sexual activity?

About 1 week before resuming sexual activity, or until you feel comfortable.

How long before I see results?

Since it takes approximately 72 days for spermatogenesis, you may expect results, if any, approximately 3 months later.  At this time, a semen analysis should be scheduled.

When are the stitches removed?

The stitches will dissolve; there is no need to have them removed.

What does the post-surgical care entail?

After the procedure, you will be groggy.  You must arrange for someone to pick you up and take you home directly.  The doctor will have prescribed pain medication and antibiotics, which you should take as needed.  It is recommended that you rest for at least the remainder of the day.  It is normal that the area be slightly discolored and tender.  You may bathe, washing the area gently, after 48 hours.  You should call to schedule a post-operative appointment 1-2 weeks after the procedure.

Be sure to notify the doctor immediately if there is discharge from the wound or you develop a fever.

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