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How are Varicoceles Treated?

Often, varicoceles are not treated. Treatment is offered for males who have:

  • fertility problems (problems fathering a child)
  • pain
  • the left testicle growing more slowly than the right

Boys with a smaller left testicle are thought to have a higher risk for fertility problems when they get older.

There are no drugs to treat or prevent varicoceles. But pain killers (such as acetaminophen or ibuprofen) may help with pain.

When needed, surgery is the main form of treatment. Embolization (briefly blocking the veins) is a non-surgical treatment option.

Surgery

There are many ways to do varicocele surgery. All involve blocking the blood flow in the pampiniform plexus veins.

Open Surgery

Open surgery repair is done through a single 1 inch cut. The surgeon may use a magnifying glass or operating microscope to see small veins. The surgery can be done under local or general anesthesia.

Laparoscopic Surgery

Laparoscopic surgery is done through thin tubes put into your body through a small cut. The surgeon uses a special camera to see inside your body. Laparoscopic surgery is done under general anesthesia.

Surgery Results

Since surgeons have started using smaller cuts through the muscle for open surgery, healing time and pain are about the same with open and laparoscopic surgery. Problems after either surgery are rare. Problems include:

  • varicocele remaining (persistence) or coming back (recurrence)
  • fluid forming around the testicle (hydrocele)
  • injury to the testicular artery

There is a small chance surgery won't correct the problem. In rare cases, injury to the testicular artery can lead to loss of the testicle. Persistence or recurrence of the varicocele happens in fewer than 1 of 10 patients who have surgery. Open surgery done with magnification has a low persistence rate or chance of varicocele coming back.

Most of the time, patients return to normal activities after 2 days with little pain.

Percutaneous Embolization

Embolization is done by a radiologist. A special tube is put into a vein in either the groin or neck. An X-ray is used to check the enlarged pampiniform plexus veins. Then coils or balloons are opened through the tube to block the veins. This halts the blood flow in the pampiniform plexus veins and the varicocele shrinks. Percutaneous embolization is most often done with general anesthesia. It often takes several hours. Some problems are:

  • varicocele remaining (persistence) or coming back (recurrence)
  • the coil moving from where it was placed
  • a chance of infection where the tube was placed

This method isn't used at most centers.