Why varicocele is not a simple operation at all?
7 important facts you need to know about varicocele:
What is Varicocele
Varicocele is the dilatation of testicular veins starting from early puberty. Varicocele is present in 15% of the male population and is the most frequent reason of male infertility.
1- What harms varicocele can cause?
Varicocele starts at puberty, increases its effects by time an may cause;
- Decrease of male hormone testosterone
- Arrested growth of testicle or it’s atrophy
2- How should varicocele be diagnosed?
Varicocele should be diagnosed by manual examination of an Andrologist that is experienced on this topic. Use of duplex ultrasonography may cause over diagnosis and unnecessary operations that patients will not benefit. Varicocele is not an emergency, should be treated in 2-3 months time.
3- Why should microsurgery be preferred?
The most successful method of repairing a varicocele with the lowest complication risk is microsurgery applied by trained and experienced surgeons. In the last 24 years, I did as nearly 5000 microsurgical varicocele operations; the rate of technical achievement is over 99% in my line, the rate of serious complications is 0% and insignificant minor complication rate is 3%. With other methods than microsurgery, varicocele continues to exist in 40% of treated patients, risk of hydrocele (swelling of testicle due to fluid accumulation between its membranes) is up to 40%, and arterial damage may be up to 5%. Embolization as a radiological method to treat varicocele should not be preferred because it has low success rate and high rates of serious complications. Varicocele cannot be cured with medication or herbal remedies.
4- Is varicocele a simple surgery?
- In our day, varicocele surgery without using microsurgical technique is only used in centers that can’t perform microsurgery and better be avoided.
- Microsurgical varicocele operation is definitely not a simple procedure, it should only be performed by Urologists with microsurgical skills or it may fail or cause serious complications, even loss of the organ. If a microsurgical operation is not performed adequately it can still be corrected with another microsurgery. In my series approaching 5000 cases; more than 80% of patients achieved increase in semen test values with pregnancies in many and the diminishment was stopped in the remaining.
5- Does varicocele recur after operation?
Varicocele does not repeat after a successful microsurgical operation. It is misdefined as a ‘recurrence’ if it is not completely eradicated by the operation. I am recently performing increasing numbers of re-operations to correct unsuccessful microsurgery attempts and operations performed without microsurgery. My patients achieve pregnancies and positive results after these corrective surgeries.
6- What if we first try IVF-ICSI instead of varicocele operation?
Assisted reproductive techniques should not be performed in couples who have a varicocele diagnosed. Varicocele effects chromosomal structure of the sperm (DNA fragmentation index; DFI) and causes low fertilization rates and increased abortion percentages. Pregnancies can be achieved after varicocele operation in patients who have many failed IVF-ICSI attempts. Increase of birth anomalies by 30% in babies, early menopause and some serious side effects for the mother should also be considered and IVF-ICSI should remain as the last resort.
7- If you have a varicocele or you did not benefit from varicocele operation…
This website aims to inform about varicocele. I only answer questions that do not have an answer in this website.
Please do not send me your semen analysis or ultrasound reports to ask my opinion; I only diagnose varicocele by examining with my own hands and I only evaluate semen analysis performed by Andrology laboratory staff that I specially educated (Istanbul Medical School Andrology Lab. or Biruni Lab. Etiler branch (+90 212 358 5100)
As I see and operate many international patients please contact in advance for fast processing time and help with additional needed services for your visit by mailing to [email protected]