Materiały źródłowe

• #1 Varicocele – Charlotte, NC: South Charlotte General and Vascular Surgery

  https://www.scgvs.com/contents/conditions/varicocele

  A varicocele is a collection of dilated blood vessels in the scrotum and around the testicles. Varicoceles can be associated with male infertility in 40% of couples and they are the most correctable cause of male infertility. […] At South Charlotte General and Vascular Surgery, our vascular surgeons have extensive experience in the diagnosis and treatment of these conditions and are able to treat the condition with a procedure done in our state of the art in-office accredited angiography suite. […] Treatment of varicoceles is indicated if: Palpable painful varicocele, Documented infertility with no female infertility issues or potentially curable problem, Abnormal sperm analysis, The left testicle growing smaller than the right. […] The goals of treating the varicocele is to eliminate the pressure in the veins of the testicle by closing off the bad veins and diverting the blood flow into healthier veins.

• #2 Varicocele – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/varicocele/symptoms-causes/syc-20378771

  A varicocele may cause poor development of a testicle, low sperm production or other problems that may lead to infertility. Surgery to treat varicocele may be recommended to address these complications. […] A varicocele doesn’t necessarily cause infertility. An estimated 10% to 20% of men diagnosed with a varicocele experience difficulty fathering a child. Among men with fertility problems, about 40% have a varicocele.

• #3 Varicocele: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/varicocele

  A varicocele can result in decreased sperm production and quality, which in some cases can lead to infertility. […] Varicocele is present in 35 to 44 percent of men with primary infertility and 45 to 81 percent of men with secondary infertility. […] You may want to consider treatment if the varicocele causes infertility. […] The earlier you start treatment, the better your chances of improving sperm production. […] Additional treatment, like varicocelectomy and varicocele embolization, might be necessary if your symptoms get worse. […] A varicocelectomy is a same-day surgery thats performed in a hospital. […] Varicocele embolization is a less invasive, same-day procedure. […] Surgery is only necessary if the varicocele is causing you pain or if youre trying to have a child.

• #4 Varicocele – Charlotte, NC: South Charlotte General and Vascular Surgery

  https://www.scgvs.com/contents/conditions/varicocele

  A varicocele is a collection of dilated blood vessels in the scrotum and around the testicles. Varicoceles can be associated with male infertility in 40% of couples and they are the most correctable cause of male infertility. […] At South Charlotte General and Vascular Surgery, our vascular surgeons have extensive experience in the diagnosis and treatment of these conditions and are able to treat the condition with a procedure done in our state of the art in-office accredited angiography suite. […] Treatment of varicoceles is indicated if: Palpable painful varicocele, Documented infertility with no female infertility issues or potentially curable problem, Abnormal sperm analysis, The left testicle growing smaller than the right. […] The goals of treating the varicocele is to eliminate the pressure in the veins of the testicle by closing off the bad veins and diverting the blood flow into healthier veins.

• #5 Varicocele – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/varicocele/diagnosis-treatment/drc-20378772

  A varicocele often doesn’t need to be treated. For a man experiencing infertility, surgery to correct the varicocele may be a part of the fertility treatment plan. […] Surgery might be recommended in the following situations: A testicle that shows delayed development, Low sperm count or other sperm irregularities (usually only tested in adults), Chronic pain not managed by pain medication. […] The purpose of surgery is to seal off the affected vein to redirect the blood flow into healthy veins. This is possible because two other artery-and-vein systems supply blood circulation to and from the scrotum. […] Treatment outcomes may include the following: The affected testicle eventually may return to its expected size. In the case of a teenager, the testicle may „catch up” in development. Sperm counts may improve, and sperm irregularities may be corrected. Surgery may improve fertility or improve semen quality for in vitro fertilization.

• #6 Varicocele Treatment & Management: Medical Therapy, Surgical Therapy, Preoperative Details

  https://emedicine.medscape.com/article/438591-treatment

  The primary form of treatment for varicoceles is surgery. Because of the potential to cause significant testicular damage, evaluate the varicocele during the physical examination. The presence of a varicocele does not in itself mean surgical correction is necessary. […] The ultimate goals of varicocele repair should include occlusion of the offending varicosity, preservation of arterial flow to the testis, and minimization of patient discomfort and morbidity. […] Results from a prospective, randomized controlled trial from Saudi Arabia compared subinguinal microsurgical varicocele repair to observation. […] This study provided an evidence-based endorsement of the superiority of varicocelectomy over observation in infertile men with palpable varicoceles and impaired semen quality. […] Surgical techniques for varicocele repair include retroperitoneal, laparoscopic, inguinal, and subinguinal. The microsurgical subinguinal approach is the gold standard.

• #7 Varicocele: Varicose Veins in Testicles – Symptoms, Treatment – Urology | UCLA Health

  https://www.uclahealth.org/medical-services/urology/conditions-treated/male-conditions/varicocele-symptoms-treatment-diagnosis

  Varicocele treatment can include surgical repair, which can help to restore fertility when the varicocele is the source of the problem. […] Varicocele treatment is generally necessary only for infertility, or if the varicocele causes persistent pain or discomfort (even after attempting non-surgical varicocele treatment such as anti-inflammatory medications and wearing snug underwear or a jock strap) or significant testicular atrophy. […] Surgical treatment of the varicocele usually involves tying off the affected vein to redirect the blood flow toward normal veins. Surgery can be open or laparoscopic and is done on an outpatient basis. Surgery using a surgical microscope, offered at UCLA, can allow precise identification of critical structures that need to be preserved during surgery, such as the testicular artery. Pain after the surgery is mild, and often the patient can return to most normal activities within two days. Treating varicocele is typically successful and approximately half of men who have the surgery to correct infertility are able to father a child within the first year.

• #8 Varicocele Microsurgery | Schedule Varicocelectomy Surgery with UH Surgeons & Doctors in Northeast Ohio | University Hospitals

  https://www.uhhospitals.org/services/urology-services/conditions-and-treatments/mens-sexual-health/varicocele-repair

  If the varicocele is causing you pain or you are concerned about your fertility, your doctor may recommend one of the following surgical procedures: […] Varicocele Microsurgery. This is the gold standard for treatment and has lower complication rates than embolization. The procedure is done in the operating room under general anesthesia. A surgeon with advanced training in microsurgical varicocelectomy, makes a small incision in your groin through which the spermatic cord is identified and visualized through a microscope. Taking great care to avoid injury to the testicular artery, the enlarged veins are identified and permanently tied off to stop the poor blood flow. Blood can then flow around the abnormal veins to the normal ones, improving testicular function. Varicocele repair can improve pain, sperm counts, sperm motility (the ability of your sperm to move) and the quality of your sperm. […] The urology specialists at University Hospitals understand the sensitive nature of your concerns. We provide the utmost in compassionate, professional care and will explain your treatment options for varicocele and any other mens health issues that may be a concern.

• #9 Testicular Varicocele Treatments, Understand Your Options azura-logo-white

  https://www.azuravascularcare.com/infovaricocele/testicular-varicocele-treatment-options/

  If you have been diagnosed with, or suffer from pain or infertility caused by a varicocele, seeking treatment is your best choice for symptomatic relief. The ultimate goals of varicocele treatment are to correct the backward flow of blood from the scrotum towards the heart and to minimize discomfort. […] There are several surgical approaches used to close off, or ligate, the varicose vein and repair the varicocele, including open surgery (with a relatively high incidence of recurrence), microsurgery (lower recurrence rate but technically complex), or laparoscopy (requiring general anesthesia with higher complication rates). […] In the past surgery was the only method to treat varicoceles, but today men have another option. […] Varicocele embolization is a minimally invasive outpatient procedure that requires no incision or sutures and allows for a much faster recovery than surgery.

• #10 Management options of varicoceles

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3114590/

  Varicocele is one of the most common causes of male infertility. Treatment options for varicoceles includes open varicocelectomy performed at various anatomical levels. Laparoscopic varicocelectomy has been established to be a safe and effective treatment for varicoceles. Robotic surgery has been introduced recently as an alternative surgical option for varicocelectomy. Microsurgical varicocelectomy has gained increasing popularity among experts in male reproductive medicine as the treatment of choice for varicocele because of its superior surgical outcomes. […] Employment of these advanced techniques of varicocelectomy can provide a safe and effective approach aiming to eliminate varicocele, preserve testicular function and, in a substantial number of men, increase semen quality and the likelihood of pregnancy.

• #11 Varicocele Treatment & Management: Medical Therapy, Surgical Therapy, Preoperative Details

  https://emedicine.medscape.com/article/438591-treatment

  A varicocele is an anatomic abnormality that can impair sperm production and function. No effective medical treatments for varicoceles have been identified. Some evidence supports the use of dietary supplements, including vitamins A, E, C, and B complex; glutathione; pantothenic acid; coenzyme Q10; carnitine; and micronutrients such as zinc, selenium, and copper. These may increase levels of antioxidant enzymes and decrease levels of inflammatory markers. […] In elderly men, impairment of Leydig cell function by varicocele can compound the decrease in testosterone production that occurs with aging, resulting in hypogonadism. Testosterone replacement therapy is an option in these patients, who are unlikely to be concerned with fertility. Nevertheless, while the possibility of avoiding surgery may appeal to these patients, with education about their options they may conclude that a one-time low-risk microsurgery is preferable to lifelong testosterone therapy with laboratory monitoring.

• #12 Varicocele in Adolescents Treatment & Management: Approach Considerations, Medical Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/1016840-treatment

  No known medical therapy is available for varicocele. […] Surgical ligation of the spermatic veins is the procedure used. […] A systematic review and meta-analysis by Fabiani et al compared surgical ligation with sclero-embolization for treatment of varicocele in children, adolescents and adults. […] The aim of varicocele surgery is to identify and ligate the ascending venous network that drains the testis, epididymis, and vas deferens. […] Varicocele ligation is an outpatient procedure. […] Varicocelectomy, regardless of the technique employed, carries a risk of complications. […] Hydrocele formation is the most common complication of varicocelectomy and most likely results from lymphatic obstruction. […] Less common complications include testicular atrophy, hematoma, injury to the vas deferens, chronic testicular pain, and recurrence or persistence of the varicocele. […] Routine postoperative visits for wound and testicular assessment are standard.

• #13

  https://www.aurorahealthcare.org/services/urology/varicoceles

  We treat a variety of male reproductive issues with empathy, including erectile dysfunction, infertility and varicoceles. […] If a varicocele causes significant discomfort or affects fertility, medical treatment may be considered. […] Most varicoceles go away with proper treatment. However, larger varicoceles may cause complications such as low testosterone and infertility. […] It’s important to note that many varicoceles are asymptomatic and might be discovered incidentally during a physical exam. If you suspect you have a varicocele or are experiencing any symptoms in the scrotum, contact your provider to schedule an appointment. […] Varicocele treatment is recommended based on the severity (grade) of your varicocele. For less severe varicoceles, your provider may recommend at-home treatment that includes the use of ice packs, making lifestyle changes or taking over-the-counter medications such as naproxen and ibuprofen for pain relief from varicoceles. […] If your varicoceles are severe, your doctor may recommend a varicocelectomy, a surgical procedure to redirect blood flow to healthy veins in the scrotum.

• #14 Varicocele Treatment & Management: Medical Therapy, Surgical Therapy, Preoperative Details

  https://emedicine.medscape.com/article/438591-treatment

  A varicocele is an anatomic abnormality that can impair sperm production and function. No effective medical treatments for varicoceles have been identified. Some evidence supports the use of dietary supplements, including vitamins A, E, C, and B complex; glutathione; pantothenic acid; coenzyme Q10; carnitine; and micronutrients such as zinc, selenium, and copper. These may increase levels of antioxidant enzymes and decrease levels of inflammatory markers. […] In elderly men, impairment of Leydig cell function by varicocele can compound the decrease in testosterone production that occurs with aging, resulting in hypogonadism. Testosterone replacement therapy is an option in these patients, who are unlikely to be concerned with fertility. Nevertheless, while the possibility of avoiding surgery may appeal to these patients, with education about their options they may conclude that a one-time low-risk microsurgery is preferable to lifelong testosterone therapy with laboratory monitoring.

• #15 Varicocele Treatment & Management: Medical Therapy, Surgical Therapy, Preoperative Details

  https://emedicine.medscape.com/article/438591-treatment

  A varicocele is an anatomic abnormality that can impair sperm production and function. No effective medical treatments for varicoceles have been identified. Some evidence supports the use of dietary supplements, including vitamins A, E, C, and B complex; glutathione; pantothenic acid; coenzyme Q10; carnitine; and micronutrients such as zinc, selenium, and copper. These may increase levels of antioxidant enzymes and decrease levels of inflammatory markers. […] In elderly men, impairment of Leydig cell function by varicocele can compound the decrease in testosterone production that occurs with aging, resulting in hypogonadism. Testosterone replacement therapy is an option in these patients, who are unlikely to be concerned with fertility. Nevertheless, while the possibility of avoiding surgery may appeal to these patients, with education about their options they may conclude that a one-time low-risk microsurgery is preferable to lifelong testosterone therapy with laboratory monitoring.

• #16 Reddit – The heart of the internet

  https://www.reddit.com/r/varicocele/comments/16ywox3/how_i_improved_my_varicocele/

  I decided I should get treatment for the left side, which was done in October, 2021. […] Even though the treatment was a success, about a year later (2022), my varicocele on the left side started to come back. […] I came across an article that showed a correlation between varicoceles, and low levels of Vitamin K. I decided to try increasing my Vitamin K levels in hopes I would get some relief. […] Now, I am following-up with my progress since I started taking Vitamin K, one month ago. […] My varicoceles on both sides have decreased in swelling. […] For those who are interested, my regiment is 15mg (yes milligrams, not micrograms) Vitamin K2, every other day.

• #17 Varicocele (for Teens) | Nemours KidsHealth

  https://kidshealth.org/en/teens/varicocele.html

  Most varicoceles need no special treatment. A varicocele is usually harmless and more than likely won’t affect a guy’s ability to father a child later in life. […] But if there is any pain and swelling, the doctor may prescribe an anti-inflammatory medicine to relieve it. If the varicocele causes discomfort or aching, wearing snug underwear (like briefs) or a jock strap for support may bring relief. […] If the doctor thinks the testicle is being affected by the varicocele or if there’s still pain and support doesn’t help, a type of surgery called a varicocelectomy may be recommended. This is done by a urologist, a doctor who specializes in urinary and genital problems. The urologist will discuss the different ways a varicocelectomy can be done and recommend the best approach for the patient.

• #18 Varicocele I Ohio State Urology Department

  https://wexnermedical.osu.edu/urology/varicocele

  A varicocele is usually harmless and may not need treatment. A „jock strap” (scrotal support) or snug underwear may help relieve the pain or discomfort. If pain continues or other symptoms occur, you may need further treatment. Surgical treatment may increase sperm count but may not increase the likelihood of getting a woman pregnant. In most cases, testicular wasting (atrophy) does not improve unless surgery is done early in adolescence. […] Varicocelectomy is surgery to correct a varicocele. It involves the use of numbing medication and a small cut, usually in the lower abdomen, to tie off the abnormal veins. This allows blood to flow around the area into normal veins. […] Varicocele embolization involves a small tube placed in the vein that is guided by X-ray. A tiny coil passes through the tube into the varicocele. The coil blocks blood flow to the bad vein, and sends blood to normal veins.

• #19 Management options of varicoceles

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3114590/

  Varicocelectomy is by far the most commonly performed operation for the treatment of male infertility. The indications of varicocelectomy for clinically significant varicoceles include (1) infertility, particularly with impaired semen parameters or sperm quality, (2) hypogonadism, (3) scrotal pain, (4) testicular hypotrophy, particularly in the pediatric population and (5) aesthetic issues with large varicoceles. Treatment options for varicocele can be divided into two major categories: (1) percutaneous occlusion, by intravenous injection of various materials to occlude the varicoceles and (2) surgical ligation or clipping of the varicoceles to prevent venous reflux. […] Surgical repair remains the most popular form of treatment for varicocele and it can be achieved by conventional open varicocelectomy (retroperitoneal high ligation, inguinal and sub-inguinal ligation), laparoscopic/robotic varicocelectomy and microsurgical varicocelectomy.

• #20 Varicocele Treatment & Management: Medical Therapy, Surgical Therapy, Preoperative Details

  https://emedicine.medscape.com/article/438591-treatment

  The primary form of treatment for varicoceles is surgery. Because of the potential to cause significant testicular damage, evaluate the varicocele during the physical examination. The presence of a varicocele does not in itself mean surgical correction is necessary. […] The ultimate goals of varicocele repair should include occlusion of the offending varicosity, preservation of arterial flow to the testis, and minimization of patient discomfort and morbidity. […] Results from a prospective, randomized controlled trial from Saudi Arabia compared subinguinal microsurgical varicocele repair to observation. […] This study provided an evidence-based endorsement of the superiority of varicocelectomy over observation in infertile men with palpable varicoceles and impaired semen quality. […] Surgical techniques for varicocele repair include retroperitoneal, laparoscopic, inguinal, and subinguinal. The microsurgical subinguinal approach is the gold standard.

• #21 Should Varicocele Be Treated? What Happens If Surgery Is Not Performed?

  https://dreminozbek.com/en/should-varicocele-be-treated-what-happens-if-surgery-is-not-performed/

  Should Varicocele Be Treated? What Happens If Surgery Is Not Performed? […] If left untreated, it will cause infertility and sexual dysfunction in the future. […] The most effective method in the treatment of the disease is varicocele surgery performed by microsurgical method. […] Among these treatment options, the most effective method and now considered the gold standard treatment is microsurgery. […] Varicocele surgery is no longer performed using the laparoscopic method. […] For these reasons, microsurgical varicocelectomy is considered a gold standard treatment method in the treatment of varicocele. […] Not every varicocele requires surgery. […] In the following cases, varicocele surgery must be performed: […] If varicocele is left untreated, it causes serious sexual problems (sexual dysfunction) along with infertility.

• #22 Varicocele Microsurgery | Schedule Varicocelectomy Surgery with UH Surgeons & Doctors in Northeast Ohio | University Hospitals

  https://www.uhhospitals.org/services/urology-services/conditions-and-treatments/mens-sexual-health/varicocele-repair

  If the varicocele is causing you pain or you are concerned about your fertility, your doctor may recommend one of the following surgical procedures: […] Varicocele Microsurgery. This is the gold standard for treatment and has lower complication rates than embolization. The procedure is done in the operating room under general anesthesia. A surgeon with advanced training in microsurgical varicocelectomy, makes a small incision in your groin through which the spermatic cord is identified and visualized through a microscope. Taking great care to avoid injury to the testicular artery, the enlarged veins are identified and permanently tied off to stop the poor blood flow. Blood can then flow around the abnormal veins to the normal ones, improving testicular function. Varicocele repair can improve pain, sperm counts, sperm motility (the ability of your sperm to move) and the quality of your sperm. […] The urology specialists at University Hospitals understand the sensitive nature of your concerns. We provide the utmost in compassionate, professional care and will explain your treatment options for varicocele and any other mens health issues that may be a concern.

• #23 Management options of varicoceles

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3114590/

  The introduction of microsurgical techniques in varicocelectomy significantly reduced the persistence/recurrence rate (0-2%) and the complication rate (1-5%). This outpatient procedure can be performed under local, regional or general anesthesia and the operating time per side is 25-60 min. Male infertility specialists in most academic centers have adopted microsurgical subinguinal varicocelectomy as the routine standard treatment. This general trend of increasing popularity of microsurgical varicocelectomy is largely due to the associated favorable outcomes. Even in cases of persistent or recurrent varicocele after initial varicocele therapy, microsurgical subinguinal varicocelectomy can further improve semen parameters, serum testosterone levels and testicular volume from pre-operative levels with minimal risks of complications.

• #24 Varicocele Treatment & Management: Medical Therapy, Surgical Therapy, Preoperative Details

  https://emedicine.medscape.com/article/438591-treatment

  A meta-analysis found that although microsurgical varicocelectomy involves a longer operative time, it has a lower incidence of postoperative complications and recurrence than laparoscopic and open varicolectomies and a shorter time to return to work, as well as a greater increase in postoperative sperm concentration, better improvement in postoperative sperm motility, and a higher pregnancy rate. […] Microsurgical repair of varicocele may improve the patient’s erectile and ejaculatory function, along with raising testosterone levels. […] In patients with a left clinical varicocele accompanied by a right subclinical varicocele, the choice of unilateral versus bilateral varicocelectomy has been controversial. However, studies have shown superior improvement in sperm parameters and spontaneous pregnancy rates with bilateral varicocelectomy in these patients.

• #25 Management options of varicoceles

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3114590/

  Utilizing microsurgical artery- and lymphatic-sparing techniques, the recurrence rates are reduced to 1% and the post-operative hydrocele and testicular atrophy is virtually eliminated. Repair of large varicocele results in a 143% increase in motile sperm in the ejaculate and a pregnancy rate of 47% at 1 year. Even men with non-obstructive azoospermia may respond to varicocelectomy with return of sperm to the ejaculate in 21-55% of the cases, obviating the need for testicular sperm retrieval for intra-cytoplasmic sperm injection. […] While various approaches are available to correct varicoceles, it is evident from the current literature that each technique has its own strengths and limitations. With the lack of large-scale randomized control trials to compare the efficacies, cost-effectiveness and complications of the various treatment options currently available for varicoceles, it is impossible to draw a valid conclusion as to which technique is the best treatment choice for an individual affected by varicoceles. What is certain, however, is that the treatment outcomes are highly dependent on the experience and skill of the treating physicians.

• #26 Varicocele Treatment Options | Varicocele Doctor

  https://varicoceledoctor.com/services/treatment-options/

  Non-Surgical Embolization Varicocele embolization is a minimally invasive treatment that utilizes the bodys anatomy to get to the abnormal veins without opening up the skin. […] Varicocele is a commonly found and diagnosed condition that leads to infertility for men. […] Varicoceles are enlarged veins in the scrotum which cause the testicle to appear larger. This condition causes pain and can also lead to male infertility. […] Treatment Options Non-Surgical Embolization Varicocele embolization is a minimally invasive treatment that utilizes the bodys anatomy to get to the abnormal veins without opening up the skin. […] Varicocele Surgery Microsurgical Varicocelectomy. […] Varicocele Surgery Laparoscopic Varicocelectomy.

• #27 Varicocele – Charlotte, NC: South Charlotte General and Vascular Surgery

  https://www.scgvs.com/contents/conditions/varicocele

  Up until recently, the treatment of varicoceles has primarily consisted of surgical removal of the dilated veins. […] Here are some of the options to consider: Open varicocelectomy: This approach involves an incision in the inguinal, or groin, region. The surgeon locates the veins causing the varicocele and ties them off. […] Laparoscopic varicocelectomy: This approach involves small incisions made in the abdomen. Using a specialized camera (scope), the veins that are causing the varicocele are identified and then tied off. […] Microsurgical varicocelectomy: This approach uses the same initial incision as the open approach, however it uses a microscope to locate the veins and tie them off. This procedure is more time intensive than the other procedures. […] Varicocele Embolization: At South Charlotte General and Vascular Surgery, our specialists have had excellent results with treating this condition with an in-office procedure, where they are able to place metal coils inside the enlarged veins to shrink them. This is a treatment that does not require surgery.

• #28 Varicocele | Tennessee | Urology Associates P.C.

  https://www.urologynashville.com/conditions/for-men/varicocele/

  Most varicoceles dont require treatment. If you experience pain or atrophy of the testicle or if you are infertile, you may wish to undergo one of several treatments: […] Microsurgical varicocelectomy is usually considered to be the best treatment for relieving pain caused by the varicocele, and also to improve semen parameters, testicular function, and pregnancy rates in couples with male factor infertility associated with varicocele. […] Laparoscopy may have the advantage of identifying veins higher up, where your surgeon likely will need to tie off fewer veins. […] Percutaneous embolization is usually performed when other approaches have failed. […] These procedures do not guarantee fertility; talk with your doctor to fully understand your potential risks and benefits. […] Varicoceles are a common cause of male infertility and the most common cause of sperm production problems that can lead to male infertility.

• #29 Varicoceles: Overview of Treatment from a Radiologic and Surgical Perspective

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9767781/

  Surgical intervention of varicocele involves obstructing the reflux of venous drainage to the testes. […] Varicocelectomy is the most performed surgical intervention for varicocele, with multiple approaches described in the literature. […] The open microsurgical approach has the strongest evidence for the lowest recurrence rates, fewer complications, and highest improvement in pregnancy rates and sperm parameters when compared to laparoscopic or retroperitoneal approaches. […] There is controversy in the literature as to which surgical approach is best. […] Retrograde embolization is an outpatient procedure performed under moderate sedation with patients in the supine position. […] Multiple methods of embolization that can be used including mechanical embolization (plugs, metallic coils), liquid embolic agents, sclerosants, as well as different combinations of the three.

• #30 Should Varicocele Be Treated? What Happens If Surgery Is Not Performed?

  https://dreminozbek.com/en/should-varicocele-be-treated-what-happens-if-surgery-is-not-performed/

  Should Varicocele Be Treated? What Happens If Surgery Is Not Performed? […] If left untreated, it will cause infertility and sexual dysfunction in the future. […] The most effective method in the treatment of the disease is varicocele surgery performed by microsurgical method. […] Among these treatment options, the most effective method and now considered the gold standard treatment is microsurgery. […] Varicocele surgery is no longer performed using the laparoscopic method. […] For these reasons, microsurgical varicocelectomy is considered a gold standard treatment method in the treatment of varicocele. […] Not every varicocele requires surgery. […] In the following cases, varicocele surgery must be performed: […] If varicocele is left untreated, it causes serious sexual problems (sexual dysfunction) along with infertility.

• #31 Treatment of Varicoceles – Charlotte, NC: South Charlotte General and Vascular Surgery

  https://www.scgvs.com/contents/treatments/varicocele-treatment

  The goals of treating the varicocele is to eliminate the pressure in the veins of the testicle by closing off the bad veins and diverting the blood flow into healthier veins. Up till recently, the treatment of varicoceles has primarily consisted of surgical removal of the dilated veins. Although successful, the surgical procedure has risks associated with it, some of which may be quite disabling. […] Open varicocelectomy: This approach involves an incision in the inguinal, or groin, region. The surgeon locates the veins causing the varicocele and ties them off. The surgery is effective but carries a risk of developing some complications and is currently reserved for patients who fail or recur after embolization. […] Laparoscopic varicocelectomy: This approach involves small incisions made in the abdomen. Using a specialized camera (scope), the veins that are causing the varicocele are identified and then tied off.

• #32 Varicocele – Charlotte, NC: South Charlotte General and Vascular Surgery

  https://www.scgvs.com/contents/conditions/varicocele

  Up until recently, the treatment of varicoceles has primarily consisted of surgical removal of the dilated veins. […] Here are some of the options to consider: Open varicocelectomy: This approach involves an incision in the inguinal, or groin, region. The surgeon locates the veins causing the varicocele and ties them off. […] Laparoscopic varicocelectomy: This approach involves small incisions made in the abdomen. Using a specialized camera (scope), the veins that are causing the varicocele are identified and then tied off. […] Microsurgical varicocelectomy: This approach uses the same initial incision as the open approach, however it uses a microscope to locate the veins and tie them off. This procedure is more time intensive than the other procedures. […] Varicocele Embolization: At South Charlotte General and Vascular Surgery, our specialists have had excellent results with treating this condition with an in-office procedure, where they are able to place metal coils inside the enlarged veins to shrink them. This is a treatment that does not require surgery.

• #33 Non-Surgical Testicular Varicocele Treatment Options | Azura azura-logo-white

  https://www.azuravascularcare.com/infovaricocele/non-surgical-testicular-varicocele-treatment/

  If you are experiencing ongoing or recurring varicocele, you’re probably finding yourself faced with making a decision about what the next step is to treat your condition. […] If you’re looking for a varicocele treatment option that avoids surgery, you do have an alternative. Varicocele embolization is a non-surgical, minimally invasive treatment that offers many advantages over surgery. […] Varicocele embolization is less invasive, so the risks are naturally reduced in comparison to surgery. An overnight hospital stay is not necessary, and men typically return to work more quickly than after surgery. Varicocele embolization is considered cost effective as compared to surgery. […] If you’re hoping to find a varicocele treatment option that is less invasive and has a quicker recovery time than surgery, talk to your doctor about the possibility of varicocele embolization. It may be the course of treatment you’ve been hoping to find.

• #34 Varicocele embolisation for enlarged veins in the testicles – Overview | Guy’s and St Thomas’ NHS Foundation Trust

  https://www.guysandstthomas.nhs.uk/health-information/varicocele-embolisation

  This information is about X-ray guided treatment for a varicocele. […] You are having a procedure called varicocele embolisation. This is a specialised, non-surgical method to treat varicoceles that cause: discomfort, swelling, problems with fertility (the ability to conceive children). […] A varicocele embolisation is a non-surgical, permanent treatment for varicoceles that cause health issues. […] Varicocele embolisation has various benefits. […] It is less invasive than surgery and does not need a cut in the scrotum. There is a lower rate of complications compared with surgery. […] Varicocele embolisation works as well as surgery. Both treatment options can give similar improvements in pain and semen (liquid containing sperm) analysis. […] A varicocele embolisation is usually an outpatient day case procedure. This means that you do not have to stay in hospital overnight.

• #35 Treatment of Varicoceles – Charlotte, NC: South Charlotte General and Vascular Surgery

  https://www.scgvs.com/contents/treatments/varicocele-treatment

  Microsurgical varicocelectomy: This approach uses the same initial incision as the open approach; however, it uses a microscope to locate the veins and tie them off. This procedure is more time intensive than the other procedures. […] Varicocele Embolization: At South Charlotte General and Vascular Surgery, our specialists have had excellent results with treating this condition with an in-office procedure, where they are able to place metal coils inside the enlarged veins to shrink them. This is a treatment that does not require surgery. Varicocele embolization is a minimally invasive technique performed by our vascular specialist. In our state of the art in-office angiographic suite. Numbing medication is injected into the skin in the groin and then a catheter, or a thin tube, is inserted into the vein in the leg. Using x-ray imaging, the catheter is advanced into the vein(s) that are causing the varicocele. Once the catheter is successfully placed the affected veins are closed off by the placement of a small coil or coils, and/or the use of a sclerosing agent.

• #36 Varicocele Male Infertility: Causes, Symptoms & Treatments

  https://radiology.ucsf.edu/patient-care/sections/ir/advanced-services/varicocele

  A varicocele is a varicose vein of the testicle and scrotum that may cause pain, testicular atrophy (shrinkage) or fertility problems. […] Open surgical ligation, performed by a urologist, is the most common treatment for symptomatic varicoceles. Varicocele embolization, a nonsurgical treatment performed by an interventional radiologist, is as effective as surgery with less risk, less pain and less recovery time. […] Currently there are two treatment options for men with varicoceles: Catheter-directed embolization or surgical ligation. […] Catheter-directed embolization is a non-surgical, outpatient treatment performed by an interventional radiologist using imaging to guide catheters or other instruments inside the body. […] Embolization is equally effective in improving male infertility and costs about the same as surgical ligation.

• #37 Varicocele Treatment & Management: Medical Therapy, Surgical Therapy, Preoperative Details

  https://emedicine.medscape.com/article/438591-treatment

  The use of the microsurgical technique has advanced the surgical treatment of this disorder by allowing optimal visualization. […] The retroperitoneal approach offers great proximal control of the spermatic vein near its insertion at the renal vein, and this approach may be accomplished laparoscopically. […] Percutaneous embolization represents the least invasive means of varicocele repair. […] In antegrade sclerotherapy for varicocele, an incision is made at the scrotal root level, a vein in the pampiniform plexus is selected and cannulated, and a sclerosing agent is mixed with air to make a foam and immediately injected into the spermatic vein under fluoroscopic guidance. […] A prospective study by Chung et al that compared scrotal antegrade sclerotherapy with laparoscopic varicocele surgery in 113 patients concluded that both procedures are safe and effective for treatment of adolescent varicocele, with a significant positive effect on testicular catch-up growth.

• #38 Non-Surgical Testicular Varicocele Treatment Options | Azura azura-logo-white

  https://www.azuravascularcare.com/infovaricocele/non-surgical-testicular-varicocele-treatment/

  If you are experiencing ongoing or recurring varicocele, you’re probably finding yourself faced with making a decision about what the next step is to treat your condition. […] If you’re looking for a varicocele treatment option that avoids surgery, you do have an alternative. Varicocele embolization is a non-surgical, minimally invasive treatment that offers many advantages over surgery. […] Varicocele embolization is less invasive, so the risks are naturally reduced in comparison to surgery. An overnight hospital stay is not necessary, and men typically return to work more quickly than after surgery. Varicocele embolization is considered cost effective as compared to surgery. […] If you’re hoping to find a varicocele treatment option that is less invasive and has a quicker recovery time than surgery, talk to your doctor about the possibility of varicocele embolization. It may be the course of treatment you’ve been hoping to find.

• #39 About Varicocele Treatment – RAYUS Radiology

  https://rayusradiology.com/services/interventional-and-vascular/varicocele-treatment/

  Varicocele is a testicular problem that causes discomfort and can cause infertility if not treated. However, it’s important to know that surgery is not your only option. You may be a candidate for a non-surgical treatment option called varicocele embolization, which blocks off the blood flow into these problem veins. At RAYUS Vascular Care, we perform this highly effective procedure in about an hour with a small incision and minimal recovery time. […] Varicocele embolization is an outpatient, image-guided procedure that uses a catheter to place a tiny coil and/or medication into the problem blood vessel to divert blood flow away from the varicocele. Unlike varicocele surgery, embolization requires no incision, stitches, or general anesthesia. Several studies have shown that embolization is just as effective as surgery and recovery is significantly less. Patients can return to full activities in a day or two, while surgery patients may need to avoid strenuous activity for several days or even weeks. Most insurance will cover varicocele embolization if they cover varicocele surgery.

• #40 Varicocele – Charlotte, NC: South Charlotte General and Vascular Surgery

  https://www.scgvs.com/contents/conditions/varicocele

  Varicocele embolization is successful about 80-90% of the time. Within 1-2 days, you should feel close to normal, and you will be able to exercise within 7-10 days. You can resume sexual intercourse after 1-2 weeks. […] Before deciding on a treatment, you should consider all of your options. If you are interested in discussing varicocele embolization, please call us and schedule a consultation with one of our varicocele specialists.

• #41 Embolization Versus Surgery For Treatment Of Varicocele | Vascular and Interventional Radiologist & Endovascular Specialist located in Midtown, New York, NY | Yosef Golowa, MD, FSIR

  https://www.drgolowa.com/post/embolization-versus-surgery-for-treatment-of-varicocele

  Varicocele embolization is a newer non-surgical option where a thin tube is inserted into the vein and a special material is used to block off the blood flow. This doesn’t require a cut and is usually easier to recover from and has less complications as reported in clinical studies. […] Varicocele embolization is a minimally invasive procedure and it can be performed without general anesthesia. During the procedure, a thin tube is inserted into a vein, from a needle puncture access, a little larger than an IV line, usually in the groin. […] Embolization has a 90% success rate and it offers long-term results equivocal with surgery with less risk. […] Men that wish to have treatment for symptomatic varicocele have choices in choosing treatment. Whether you choose surgery or embolization for varicocele treatment, it can relieve your pain and discomfort. The treatment also brings your testicles to their normal size and improves the quality and quantity of sperm. […] Evolutions in technology and medical techniques have brought alternatives to surgery that offer comparable results. If you are diagnosed with varicocele, embolization can an advantageous choice due to its efficacious track record with less risk compared to surgery.

• #42 Varicocele – Florida Interventional Specialists

  https://flinterventionalspecialists.com/varicocele/

  Embolization is equally effective in improving male infertility and costs about the same as surgical ligation. Pregnancy rates and recurrence rates are comparable to those following surgical varicocelectomy. In one study, sixty percent conceived who were treated for infertility. In another study, sperm concentration improved in 83 percent of patients undergoing embolization compared to 63 percent of those surgically ligated. Patients who underwent both procedures expressed a strong preference for embolization.

• #43 Varicocele Treatment & Management: Medical Therapy, Surgical Therapy, Preoperative Details

  https://emedicine.medscape.com/article/438591-treatment

  A systematic review and meta-analysis by Fabiani et al of complications, and recurrence rate of varicocele treatment by comparing the surgical ligature versus sclero-embolization techniques in children, adolescents and adults concluded that neither approach was superior; the incidence of postoperative hydrocele was significantly higher in the surgical ligation group, but the incidence of postoperative orchiepididymitis was significantly higher in sclero-embolization group. […] Following varicocelectomy, approximately 66-70% of patients have improved bulk semen parameters, and 40-60% of patients have increased conception rates. […] While many of the published studies are retrospective, a randomized, prospective, controlled study by Magdar and associates (1995) confirmed that varicocelectomy is an effective treatment for male subfertility.

• #44 Varicocelectomy: Purpose, Surgery, Risks & Recovery

  https://my.clevelandclinic.org/health/treatments/24234-varicocelectomy

  A varicocelectomy is a surgical procedure that treats a varicocele. It reduces testicular pain and can increase male fertility. […] Almost half of men who have male infertility choose to get a varicocelectomy to improve their chances of achieving pregnancy. Your healthcare provider may also recommend a varicocelectomy if you have a lot of testicular pain or decreased testosterone production. […] Yes, removing varicoceles improves fertility. Pregnancy rates may increase to nearly 70% after a varicocelectomy. […] Varicocelectomies are very common. Theyre the most common procedure for treating male infertility. […] Advantages of a varicocelectomy: Your fertility may increase as a result of increased sperm and testosterone production. […] A varicocelectomy treats a varicocele. It can reduce pain, improve your quality of life and improve fertility.

• #45 Varicocele Treatment

  https://www.froedtert.com/fertility/male-infertility/varicocele

  The goals of varicocele repair are to relieve pain in symptomatic cases and to improve semen quality, testicular function and pregnancy rates in couples with infertility associated with a mans varicocele. […] Varicocele repair results in a significant improvement in semen quality in 60 percent to 80 percent of men. […] Treatment options include radiologic and surgical approaches: […] Microsurgical removal of a varicocele offers a safe and effective approach to varicocele repair with preservation of testicular function, improvements in semen quality and improvements in conception rates in a significant number of men. […] Correction of varicoceles will lead to an improvement in semen quality in about two-thirds of patients, with most studies reporting unassisted pregnancy rates ranging from 30 percent to 50 percent. […] In the only prospective randomized trial of varicocele repair, the surgery group demonstrated pregnancy rates of 44 percent after one year, and as high as 76 percent up to two years after repair, as compared to a 10 percent baseline pregnancy rate for uncorrected varicoceles.

• #46 VARICOCELE AND ITS TREATMENT | Stony Brook Medicine

  https://www.stonybrookmedicine.edu/patientcare/urology/varicocele_and_its_treatment

  Varicocele is an abnormal dilatation of the veins of the pampiniform plexus. […] The goal of treatment of the varicocele is to obstruct the refluxing venous drainage to the testis while maintaining arterial inflow and lymphatic drainage. […] Varicocelectomy is the most common surgical procedure for infertility in males. […] Varicocelectomy was found to improve the biopsy score independent of the duration or size of the varicocele. […] The grade of varicocele may have significant effect upon the outcome of varicocelectomy. […] Microsurgical varicocelectomy provides a safe and effective approach to varicocele with preservation of testicular function, improvements in semen quality, and improvements in pregnancy rates in a significant number of men. […] The operation improves semen quality in 70-80% of men.

• #47 Varicocele Specialist – Century City Los Angeles, CA & Santa Monica , CA: Scott I Zeitlin, MD: Male Infertility Specialist

  https://www.drzeitlin.com/services/varicocele

  A varicocele, or enlarged veins in the scrotum, can be a common cause of male infertility and also cause discomfort. […] Most varicoceles dont cause symptoms or require treatment. However, they can cause a low sperm count and other issues with sperm production, resulting in infertility. […] Dr. Zeitlin may recommend surgery to repair your varicocele. This can improve sperm count and production and may resolve your fertility issues. […] The procedure to repair a varicocele is called a varicocelectomy, and Dr. Zeitlin performs the procedure using microsurgery. […] A varicocelectomy improves blood flow in your testicles. New sperm takes three months to develop, so it may take several months after the procedure until there are significant improvements in the count or quality of your sperm.

• #48 Varicocelectomy: Purpose, Surgery, Risks & Recovery

  https://my.clevelandclinic.org/health/treatments/24234-varicocelectomy

  A varicocelectomy is a surgical procedure that treats a varicocele. It reduces testicular pain and can increase male fertility. […] Almost half of men who have male infertility choose to get a varicocelectomy to improve their chances of achieving pregnancy. Your healthcare provider may also recommend a varicocelectomy if you have a lot of testicular pain or decreased testosterone production. […] Yes, removing varicoceles improves fertility. Pregnancy rates may increase to nearly 70% after a varicocelectomy. […] Varicocelectomies are very common. Theyre the most common procedure for treating male infertility. […] Advantages of a varicocelectomy: Your fertility may increase as a result of increased sperm and testosterone production. […] A varicocelectomy treats a varicocele. It can reduce pain, improve your quality of life and improve fertility.

• #49 Varicocele patient education fact sheet | ReproductiveFacts.org

  https://www.reproductivefacts.org/news-and-publications/fact-sheets-and-infographics/varicocele-fact-sheet/

  Treatment for a varicocele should be considered when men have associated pain or infertility with an abnormal semen analysis. […] A subclinical varicocele does not require treatment. […] Surgery is the most common treatment for a varicocele. […] Two thirds of men will see improvement in their semen analyses and about 40% can achieve a pregnancy after surgical treatment for a varicocele. […] An alternative to surgery is embolization, performed by a radiologist. […] During embolization, the radiologist uses a catheter to place a coil or fluid in the vein to block blood flow and subsequent blood pooling. […] Risks include bleeding, infection, injury to the testicle, and the risks of general anesthesia.

• #50 Varicocele – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/varicocele/diagnosis-treatment/drc-20378772

  A varicocele often doesn’t need to be treated. For a man experiencing infertility, surgery to correct the varicocele may be a part of the fertility treatment plan. […] Surgery might be recommended in the following situations: A testicle that shows delayed development, Low sperm count or other sperm irregularities (usually only tested in adults), Chronic pain not managed by pain medication. […] The purpose of surgery is to seal off the affected vein to redirect the blood flow into healthy veins. This is possible because two other artery-and-vein systems supply blood circulation to and from the scrotum. […] Treatment outcomes may include the following: The affected testicle eventually may return to its expected size. In the case of a teenager, the testicle may „catch up” in development. Sperm counts may improve, and sperm irregularities may be corrected. Surgery may improve fertility or improve semen quality for in vitro fertilization.

• #51 Varicocele Treatment & Management: Medical Therapy, Surgical Therapy, Preoperative Details

  https://emedicine.medscape.com/article/438591-treatment

  A meta-analysis found that although microsurgical varicocelectomy involves a longer operative time, it has a lower incidence of postoperative complications and recurrence than laparoscopic and open varicolectomies and a shorter time to return to work, as well as a greater increase in postoperative sperm concentration, better improvement in postoperative sperm motility, and a higher pregnancy rate. […] Microsurgical repair of varicocele may improve the patient’s erectile and ejaculatory function, along with raising testosterone levels. […] In patients with a left clinical varicocele accompanied by a right subclinical varicocele, the choice of unilateral versus bilateral varicocelectomy has been controversial. However, studies have shown superior improvement in sperm parameters and spontaneous pregnancy rates with bilateral varicocelectomy in these patients.

• #52 Varicocele – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/varicocele/diagnosis-treatment/drc-20378772

  Varicocele repair presents relatively few risks, which might include: Buildup of fluid around the testicles (hydrocele), Recurrence of varicoceles, Infection, Damage to an artery, Chronic testicular pain, Collection of blood around the testicle (hematoma). […] Your surgeon can stop the flow of blood through the testicular vein by stitching or clipping the vein shut (ligation). […] In this procedure, a vein is blocked by essentially creating a tiny dam. […] Recovery time is short with only mild pain. You’ll likely be able to return to work in 1 to 2 days and resume exercise after about a week.

• #53 Varicocele in Adolescents Treatment & Management: Approach Considerations, Medical Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/1016840-treatment

  No known medical therapy is available for varicocele. […] Surgical ligation of the spermatic veins is the procedure used. […] A systematic review and meta-analysis by Fabiani et al compared surgical ligation with sclero-embolization for treatment of varicocele in children, adolescents and adults. […] The aim of varicocele surgery is to identify and ligate the ascending venous network that drains the testis, epididymis, and vas deferens. […] Varicocele ligation is an outpatient procedure. […] Varicocelectomy, regardless of the technique employed, carries a risk of complications. […] Hydrocele formation is the most common complication of varicocelectomy and most likely results from lymphatic obstruction. […] Less common complications include testicular atrophy, hematoma, injury to the vas deferens, chronic testicular pain, and recurrence or persistence of the varicocele. […] Routine postoperative visits for wound and testicular assessment are standard.

• #54 Varicocele Treatment & Management: Medical Therapy, Surgical Therapy, Preoperative Details

  https://emedicine.medscape.com/article/438591-treatment

  A systematic review and meta-analysis by Fabiani et al of complications, and recurrence rate of varicocele treatment by comparing the surgical ligature versus sclero-embolization techniques in children, adolescents and adults concluded that neither approach was superior; the incidence of postoperative hydrocele was significantly higher in the surgical ligation group, but the incidence of postoperative orchiepididymitis was significantly higher in sclero-embolization group. […] Following varicocelectomy, approximately 66-70% of patients have improved bulk semen parameters, and 40-60% of patients have increased conception rates. […] While many of the published studies are retrospective, a randomized, prospective, controlled study by Magdar and associates (1995) confirmed that varicocelectomy is an effective treatment for male subfertility.

• #55 Management options of varicoceles

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3114590/

  The introduction of microsurgical techniques in varicocelectomy significantly reduced the persistence/recurrence rate (0-2%) and the complication rate (1-5%). This outpatient procedure can be performed under local, regional or general anesthesia and the operating time per side is 25-60 min. Male infertility specialists in most academic centers have adopted microsurgical subinguinal varicocelectomy as the routine standard treatment. This general trend of increasing popularity of microsurgical varicocelectomy is largely due to the associated favorable outcomes. Even in cases of persistent or recurrent varicocele after initial varicocele therapy, microsurgical subinguinal varicocelectomy can further improve semen parameters, serum testosterone levels and testicular volume from pre-operative levels with minimal risks of complications.

• #56 Varicocele embolisation for enlarged veins in the testicles – Overview | Guy’s and St Thomas’ NHS Foundation Trust

  https://www.guysandstthomas.nhs.uk/health-information/varicocele-embolisation

  Varicocele embolisation is a very controlled and safe procedure, but you need to be aware of some possible side effects: There may be mild bruising at the place where we put in a thin tube (catheter). […] A varicocele embolisation is an elective procedure. This means that you can choose if you have it.

• #57 Varicocele Treatment & Management: Medical Therapy, Surgical Therapy, Preoperative Details

  https://emedicine.medscape.com/article/438591-treatment

  A systematic review and meta-analysis by Fabiani et al of complications, and recurrence rate of varicocele treatment by comparing the surgical ligature versus sclero-embolization techniques in children, adolescents and adults concluded that neither approach was superior; the incidence of postoperative hydrocele was significantly higher in the surgical ligation group, but the incidence of postoperative orchiepididymitis was significantly higher in sclero-embolization group. […] Following varicocelectomy, approximately 66-70% of patients have improved bulk semen parameters, and 40-60% of patients have increased conception rates. […] While many of the published studies are retrospective, a randomized, prospective, controlled study by Magdar and associates (1995) confirmed that varicocelectomy is an effective treatment for male subfertility.

• #58 Varicocele Treatment & Management: Medical Therapy, Surgical Therapy, Preoperative Details

  https://emedicine.medscape.com/article/438591-treatment

  A systematic review and meta-analysis by Fabiani et al of complications, and recurrence rate of varicocele treatment by comparing the surgical ligature versus sclero-embolization techniques in children, adolescents and adults concluded that neither approach was superior; the incidence of postoperative hydrocele was significantly higher in the surgical ligation group, but the incidence of postoperative orchiepididymitis was significantly higher in sclero-embolization group. […] Following varicocelectomy, approximately 66-70% of patients have improved bulk semen parameters, and 40-60% of patients have increased conception rates. […] While many of the published studies are retrospective, a randomized, prospective, controlled study by Magdar and associates (1995) confirmed that varicocelectomy is an effective treatment for male subfertility.

• #59

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ug3672

  A varicocele (say „VAR-uh-koh-seel”) is a large vein that forms in the scrotum. 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. 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 steps below to get better as quickly as possible. […] 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. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if you are having problems.

• #60 Varicocele – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/varicocele/diagnosis-treatment/drc-20378772

  Varicocele repair presents relatively few risks, which might include: Buildup of fluid around the testicles (hydrocele), Recurrence of varicoceles, Infection, Damage to an artery, Chronic testicular pain, Collection of blood around the testicle (hematoma). […] Your surgeon can stop the flow of blood through the testicular vein by stitching or clipping the vein shut (ligation). […] In this procedure, a vein is blocked by essentially creating a tiny dam. […] Recovery time is short with only mild pain. You’ll likely be able to return to work in 1 to 2 days and resume exercise after about a week.

• #61 Varicocele Treatment in Atlanta | Georgia Urology

  https://www.gaurology.com/condition/varicocele/

  Varicoceles may cause progressive injury to the production and the maturation process of sperm, with worsening sperm count over time. […] The mechanism by which varicocele impairs fertility in a matter of ongoing debate. […] Not all varicoceles are associated with male infertility. […] Varicoceles affect seminal parameters in many ways. […] In the vast majority of cases, treatment is surgical. […] Different approaches include an inguinal (or groin) or laparoscopic approach. […] The procedure is performed on an outpatient basis. […] Surgical ligations (tie off) of varicoceles result in 70% of patients having improvement in their semen analysis and 40% of the couples achieving pregnancy. […] Recurrence rates are the lowest in the microscopic approach, around 1-2%. […] All types of surgery have risks of bleeding and infection. […] You should engage in only minimal activity for 24 hours and may be off work for 2-3 days.

• #62 Varicocele – Charlotte, NC: South Charlotte General and Vascular Surgery

  https://www.scgvs.com/contents/conditions/varicocele

  Varicocele embolization is successful about 80-90% of the time. Within 1-2 days, you should feel close to normal, and you will be able to exercise within 7-10 days. You can resume sexual intercourse after 1-2 weeks. […] Before deciding on a treatment, you should consider all of your options. If you are interested in discussing varicocele embolization, please call us and schedule a consultation with one of our varicocele specialists.

• #63 Varicocele Embolization | The Urology Group of Virginia

  https://www.urologygroupvirginia.com/lmg-ir-center/varicocele-embolization

  Varicocele can impair sperm production and cause infertility. Men trying to start a family or men who may want to start a family in the future, may benefit from varicocele treatment. […] What are treatment options for varicocele? Surgery, Inguinal (groin) without or with microscope, Laparoscopic, Embolization. […] The procedure takes place in an outpatient setting in our Interventional Radiology suite. This is in an office setting and does not require hospitalization. Embolization is performed with local anesthesia and sedation (twilight sleep). […] Once the vein is blocked, the damaged vein is shut off and the blood flow is redirected to the surrounding healthier veins. Pressure decreases in the varicocele which helps restore normal function and ease pain. […] Varicocele embolization usually lasts about 30 to 45 minutes. Recovery typically lasts two hours. Moderate activity is usually resumed in 24 to 48 hours. […] Advantages of varicocele embolization include office based and minimally invasive, quick recovery times, low risk of complication, no general anesthesia needed, multi-disciplinary approach, and ease of scheduling.

• #64 Varicocele Swollen Testicles Treatment at Emory Healthcare Urology Services

  https://www.emoryhealthcare.org/services/urology/treatments/varicocele-treatment

  Urologists at Emory Healthcare offer a variety of treatment options for swollen testicles caused by enlarged veins (varicocele). Our surgeons use the latest advances in varicocele treatment, including varicocele surgery. […] Varicocele surgery works by sealing or closing off the affected veins. This varicocele treatment redirects blood flow and relieves pain and swelling. […] During laparoscopic varicocele surgery, your surgeon makes a small incision in the abdomen. Then, they thread a tiny instrument through the incision to identify and repair the abnormal veins. […] The varicocele can be treated through an incision in your groin, where a microscope will be used to identify the very small branches of the vein that make up the varicocele. […] Percutaneous embolization is performed with the help of an interventional radiologist. […] Varicocele surgery may be done to address infertility for some men. You may need to wait three to four months after surgery before doctors can analyze your semen to determine if varicocele treatment worked to restore your fertility.

• #65 Varicoceles: Overview of Treatment from a Radiologic and Surgical Perspective

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9767781/

  Sodium tetradecyl sulfate (STS) sclerosant in either foam or liquid form can be used alone or in addition to coils. […] An alternative to radiological embolization is antegrade scrotal sclerotherapy, a technique first presented by Tauber and Johnsen in 1994. […] Procedural intervention for symptomatic testicular varicocele has been shown to improve pain and spermatic parameters, and increases the chance of pregnancy. […] Current evidence suggests that radiologic treatment offers a lower risk of complications and a quicker postoperative recovery compared to surgical intervention. […] Overall success rates, spermatic parameters, and pregnancy rates between radiologic and surgical techniques are comparable. […] Radiological and surgical techniques are both efficacious and safe; thus treatment course should be determined by the physician to best fit their patient’s needs.

• #66 Varicocele: To Treat or Not to Treat?

  https://www.mdpi.com/2077-0383/12/12/4062

  In summary, the strongest recommendations for varicocele repair are represented by couple infertility, OAT, grade 2 or 3 clinical varicocele, partner <37 yrs, patient age <40 yrs and testicular hypotrophy in children and adolescents. Indications are reinforced when OAT is severe and in younger patients. On the other hand, little indication exists to treat varicocele in azoospermic patients. Finally, an additional indication is represented by elevated sperm DNA fragmentation, particularly in partners of women who had undergone an unsuccessful ICSI or repeated miscarriages. [...] A conclusive answer to the Hamletic doubt of the title, to treat or not to treat varicocele, is not yet possible. Varicocele is the most common correctable cause of male infertility. In selected cases, varicocele treatment is beneficial in improving semen parameters and pregnancy rates. On the other hand, the high prevalence of the disease, together with the knowledge that many patients with varicocele are fertile, might lead to overtreatment.

• #67 Varicocele: To Treat or Not to Treat?

  https://www.mdpi.com/2077-0383/12/12/4062

  In summary, the strongest recommendations for varicocele repair are represented by couple infertility, OAT, grade 2 or 3 clinical varicocele, partner <37 yrs, patient age <40 yrs and testicular hypotrophy in children and adolescents. Indications are reinforced when OAT is severe and in younger patients. On the other hand, little indication exists to treat varicocele in azoospermic patients. Finally, an additional indication is represented by elevated sperm DNA fragmentation, particularly in partners of women who had undergone an unsuccessful ICSI or repeated miscarriages. [...] A conclusive answer to the Hamletic doubt of the title, to treat or not to treat varicocele, is not yet possible. Varicocele is the most common correctable cause of male infertility. In selected cases, varicocele treatment is beneficial in improving semen parameters and pregnancy rates. On the other hand, the high prevalence of the disease, together with the knowledge that many patients with varicocele are fertile, might lead to overtreatment.

• #68 Varicoceles: Overview of Treatment from a Radiologic and Surgical Perspective

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9767781/

  Sodium tetradecyl sulfate (STS) sclerosant in either foam or liquid form can be used alone or in addition to coils. […] An alternative to radiological embolization is antegrade scrotal sclerotherapy, a technique first presented by Tauber and Johnsen in 1994. […] Procedural intervention for symptomatic testicular varicocele has been shown to improve pain and spermatic parameters, and increases the chance of pregnancy. […] Current evidence suggests that radiologic treatment offers a lower risk of complications and a quicker postoperative recovery compared to surgical intervention. […] Overall success rates, spermatic parameters, and pregnancy rates between radiologic and surgical techniques are comparable. […] Radiological and surgical techniques are both efficacious and safe; thus treatment course should be determined by the physician to best fit their patient’s needs.

• #69 Varicocele in Adolescents Treatment & Management: Approach Considerations, Medical Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/1016840-treatment

  Moderate evidence supports the view that varicocele treatment results in improvement of testicular volume and sperm concentration. […] Ipsilateral testicular growth retardation is the most frequent relative indication for varicocele repair in adolescents; the concern is that patients with varicocele and ipsilateral testicular growth retardation at that age may manifest impaired fertility in adulthood. […] Although controversial, general guidelines used by the pediatric urologist to determine if surgery is indicated typically include the presence of one or more of the following: Varicocele associated with decreased ipsilateral testicular size – A generally accepted indication for correction is an orchidometer or ultrasonography (US) measurement revealing a 20% volume deficit in the involved testis, Bilateral varicoceles, Symptomatic painful varicocele, Abnormal findings on semen analysis.

• #70 Varicocele in Adolescents Treatment & Management: Approach Considerations, Medical Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/1016840-treatment

  The European Association of Urology (EAU) has published recommendations for management of varicocele in children and adolescents. […] In the case of absent catchup growth or sperm recovery, varicocele repair should be proposed. […] Varicocele ligation in a healthy patient has no specific contraindications, but various surgical approaches offer different advantages, and certain procedures should be avoided in specific settings. […] For this reason, when an adolescent who has previously undergone inguinal hernia surgery develops a varicocele, the best technique involves an inguinal approach with microscopic magnification to optimally identify and preserve the testicular artery. […] Further research may provide a method of adequately determining which adolescents with varicoceles are at significant risk for infertility and, thus, when intervention is warranted.

• #71 Varicocele Treatment & Management: Medical Therapy, Surgical Therapy, Preoperative Details

  https://emedicine.medscape.com/article/438591-treatment

  The use of the microsurgical technique has advanced the surgical treatment of this disorder by allowing optimal visualization. […] The retroperitoneal approach offers great proximal control of the spermatic vein near its insertion at the renal vein, and this approach may be accomplished laparoscopically. […] Percutaneous embolization represents the least invasive means of varicocele repair. […] In antegrade sclerotherapy for varicocele, an incision is made at the scrotal root level, a vein in the pampiniform plexus is selected and cannulated, and a sclerosing agent is mixed with air to make a foam and immediately injected into the spermatic vein under fluoroscopic guidance. […] A prospective study by Chung et al that compared scrotal antegrade sclerotherapy with laparoscopic varicocele surgery in 113 patients concluded that both procedures are safe and effective for treatment of adolescent varicocele, with a significant positive effect on testicular catch-up growth.

• #72 Varicocele Treatment & Management: Medical Therapy, Surgical Therapy, Preoperative Details

  https://emedicine.medscape.com/article/438591-treatment

  The persistent or recurrent varicocele can be repaired microsurgically with significant improvements in sperm concentration, percent motility, and total motile sperm per ejaculate. […] The optimal approach to varicocele ligation has not been proven in evidence-based studies. However, based on available experience and reports, the authors recommend varicocele ligation be performed through an inguinal or subinguinal approach with the use of an operating microscope and hand-held microvascular Doppler ultrasound probe.

• #73 Varicocele: To Treat or Not to Treat?

  https://www.mdpi.com/2077-0383/12/12/4062

  Current American Urological Association (AUA) and European Urology Association (EAU) guidelines suggest treating varicocele in well-selected patients when specific conditions are present. […] Overall, the available evidence supports a beneficial effect of varicolectomy on pregnancy outcomes. […] Both EAU and AUA guidelines suggest the treatment of varicocele in infertile couples. […] Varicocelectomy represents a useful and generally simple procedure for the treatment of men with oligoasthenoteratozoospermia (OAT). […] The key point, in our view, is the correct indication to treat varicocele, and selecting the right patients to treat will lead to a significant improvement in their fertility. […] In conclusion, very often, the urologist is faced with the dilemma of treating varicocele or sending the couple directly to ART.

• #74 Varicocele Treatment & Management: Medical Therapy, Surgical Therapy, Preoperative Details

  https://emedicine.medscape.com/article/438591-treatment

  The persistent or recurrent varicocele can be repaired microsurgically with significant improvements in sperm concentration, percent motility, and total motile sperm per ejaculate. […] The optimal approach to varicocele ligation has not been proven in evidence-based studies. However, based on available experience and reports, the authors recommend varicocele ligation be performed through an inguinal or subinguinal approach with the use of an operating microscope and hand-held microvascular Doppler ultrasound probe.

• #75 Varicocele Surgery, Treatment & Repair | San Diego, California

  https://www.malefertility.com/male-infertility/varicocele-surgery

  The scrotal varicocele is a well-recognized cause of decreased testicular function and is present in about 40% of infertile males and up to 80% of DI. […] A varicose vein disorder can be a cause of male infertility but is fortunately, also the most surgically correctable. […] If a varicocele is found, sometimes surgery to ligate (tie off) the abnormally dilated veins is recommended. […] If the varicocele is of significant size (Grade II or Grade III), about two thirds of men undergoing the surgery will see some improvement in sperm quality. […] The reported pregnancy rates following surgery are in the range of 40%, but most pregnancies occur 6-9 months following surgery, so the age of the female partner needs to be a major consideration. […] If the initial sperm count and sperm motility are in the severe male factor infertility category, the couple might have to consider other options such as sperm retrieval and IVF.

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