What is varicocele repair?

A varicocele (say "VAR-uh-koh-seel") is a large vein that forms in one or both sides of the scrotum. The blood builds up, or pools. This makes the vein larger than normal. To fix the problem, your doctor may tie off the veins.

A varicocele may be related to poor sperm quality. This may cause problems with fertility. The doctor can do one of several types of surgery. After the surgery, sperm quality may improve. This may help with fertility. The surgery may also be done to reduce pain in the scrotum.

The doctor may look through a microscope to see better during the surgery. The doctor makes small cuts in your groin. These cuts are called incisions. Or your doctor may choose to use a laparoscope. To do this type of surgery, the doctor puts a lighted tube, or scope, and other surgical tools through small cuts in your belly. The doctor is able to see with the scope. The surgery also can be done through a vein in the leg if the veins are being blocked rather than tied off.

You may be able to go home a few hours after the surgery. For 2 weeks after your surgery, avoid any heavy lifting or intense exercise. You will probably be able to go back to work or your normal routine in 2 to 3 days. This depends on your job. If your job involves a lot of activity or lifting, ask your doctor when you can go back to work.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• Avoid intense activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, for 2 to 3 weeks after the surgery or until your doctor says it is okay.
• For about 2 weeks after surgery, avoid lifting more than about 10 pounds. This may include a child, heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, or a vacuum cleaner.
• Ask your doctor when you can drive again.
• Most people are able to return to work 2 or 3 days after surgery. This depends on the type of work you do and how you feel. If your job involves intense activity or heavy lifting, you may need to wait 2 weeks or until your doctor says you are ready to go back.
• You may shower the next day unless your doctor tells you not to. Pat the cut (incision) dry. Do not take a bath or soak in water for 2 weeks.
• Ask your doctor when it is okay for you to have sex.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also be given instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

• A small amount of thin, clear, pinkish fluid may drain from the incision. This will last for a few days after the surgery.
• You may gently wash the incision with warm, soapy water and pat it dry, unless your doctor gives you different instructions.
• If you have strips of tape on the incision, leave the tape on until it falls off.
• You will feel a hard ridge under your skin where the incision was made. This is normal. The ridge will gradually soften up and flatten out over 3 to 6 weeks.

Ice

• To help with pain, put ice or a cold pack on your groin for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin. Try to do this every 1 to 2 hours (when you are awake) for the first day after surgery.

For those who have abnormal sperm and varicoceles that are large enough to be felt in the scrotum, research shows that surgery may increase pregnancy rates compared to not having treatment.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Risks of a varicocele repair include:

• Infection at the site of surgery.
• Fluid buildup in the scrotum (hydrocele) that requires draining or another surgery.
• Injury to the arteries to the testicle. This can cause the testicle to shrink.

Varicocele repair is most often done on an outpatient basis. You can expect to go home within a few hours of a routine varicocele surgery.

You should be able to resume light work duties 1 to 2 days after surgery and full intense activities after 2 weeks or when your doctor says you are ready.

A varicocele (say "VAR-uh-koh-seel") is a large vein that forms in the scrotum. The blood pools, making the vein larger than normal. To fix the problem, your doctor tied off the veins. After surgery, you may have slight pain in your groin for 3 to 6 weeks. Your scrotum and groin may be bruised and swollen. This will go away in 3 to 4 weeks.

You will probably be able to return to work or your normal routine in 2 to 3 days after surgery, depending on your job. If your job involves intense activity or heavy lifting, you may need to wait 2 weeks or until your doctor says you are ready to go back.

You may need to wear snug underwear or compression shorts for about 2 weeks after the surgery or as your doctor instructs you.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Take a bath or shower before you come in for your surgery. Do not apply lotions, colognes, or deodorants.
• Do not shave the surgical site yourself.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• The area for surgery is often marked to make sure there are no errors.
• You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.
• The surgery often takes 30 minutes to an hour. But it can take longer.

Varicocele repair is typically done if the pain doesn't go away or isn't relieved with treatment. And it is done to improve fertility if you have both a varicocele and impaired sperm.