Laparoscopic varicocelectomy is one of three main treatment options for varicoceles. The other two options are varicocele embolization (non-invasive) and traditional varicocelectomy (open surgery). Laparoscopic varicocele surgery is very similar to open surgery but is less invasive. It is a relatively new procedure often used as an alternative to testicular varicocele surgery with varicolectomy. Men with varicoceles associated with significant pain or those who have fertility problems often seek treatment.
A varicocele is a varicose vein in the scrotum. It occurs when the one-way valves, which are designed to allow vein flow from the scrotum and testicles to go back to the heart, do not work properly. If these valves fail to work properly, the blood pools inside the vessels, causing enlargement of the veins. Varicocele symptoms include swelling, pain, and infertility. A varicocele causes lower sperm count and poorer quality sperm and thus may cause infertility. Damage from a varicocele can also make the testicles soften and shrink. If a varicocele is causing neither pain nor infertility, then medical treatment is not always necessary. In fact, the majority of varicocele cases results in little to no symptoms at all.
Laparoscopic varicocelectomy is performed by surgeons who specialize in urologic surgery. The patient is put under general anesthesia while three surgical cuts, each approximately 5 millimeters in length, are made in the patient’s abdomen. Using tools inserted though these small incisions, including a tool to magnify the area, the surgeon can sever the enlarged veins from the healthy ones. Then veins that direct blood into an already enlarged varicocele can be tied off so that the varicocele will eventually disappear.
During a traditional varicocelectomy, one long incision is made near the top of the penis. Advantages of laparoscopy over this type of open surgery include a lower risk of damage to vital testicular arteries and reduced post-operative pain. A laparoscopic varicocelectomy procedure takes no longer than 45 minutes. Patients typically need to stay home for up to three days after the procedure in order to recover. They may experience bruising and pain where incisions were made. However, complications from laparoscopic varicocelectomy are rare. Patients usually see improvements in sperm count, sperm quality, and overall fertility within 3 months of undergoing testicular varicocele surgery. If you think you may need surgery for a varicocele and are considering laparoscopic varicocelectomy, please find a doctor for a consultation. A DoctorQA specialist is glad to evaluate your testicular varicose veins and refer you to the proper surgeon for testicular varicocele surgery.
Reviewed by Steven E. Zimmet, MD, RVT, FACPh
Editor of Phlebology
President, Zimmet Vein & Dermatology
Past-President, American College of Phlebology