What is Varicocelectomy

Varicocelectomy is a procedure to treat a varicocele. A varicocele is a swelling of veins inside the pouch that holds your testicles (scrotum). You may need this surgery if a varicocele is causing pain, shrinking your testicle, or making it hard for you to father a child (infertility).

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.

What are the risks?

Generally this is a safe procedure. However, problems may occur, including:

• Bleeding.
• Infection.
• Allergic reactions to medicines.
• Damage to the testicle.
• Damage to the blood vessels that supply the testicle.
• Fluid buildup in the scrotum (hydrocele).

What happens before the procedure?

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• Follow instructions from your health care provider about eating or drinking restrictions.
• Ask your health care provider how your surgical site will be marked or identified.
• You may be given antibiotic medicine to help prevent infection.
• Plan to have someone take you home after the procedure.

What happens during the procedure?

• An IV tube will be inserted into one of your veins.
• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • A germ-killing solution (antiseptic) will be used to wash the area where your lower abdomen meets the upper part of your leg (inguinal area). Hair may be removed from this area.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
• A small cut (incision) will be made in the inguinal area on the side where you have the varicocele.
• The cord that goes from the inguinal area to the testes (spermatic cord) will be pulled into the incision area. A microscope may be used to find all of the small veins in the cord.
• The veins will be clipped or cut and tied off.
• The spermatic cord will be put back in place.
• The incision will be closed with stitches that your body can absorb (absorbable sutures). Small adhesive strips may also be placed over the incision.
• The incision area will be covered with a light bandage (dressing).

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
• You will be given pain medicine as needed.
• You may have to wear an athletic support strap to hold the dressing in place and to support your scrotum.
• Do not drive for 24 hours if you received a sedative.

Varicocelectomy, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After your procedure, it is common to have pain, swelling, or bruising in the pouch that holds your testicles (scrotum).

Follow these instructions at home:

Bathing

• Ask your health care provider when you can shower, take baths, or go swimming.
• If you were told to wear an athletic support strap, take it off when you shower or take a bath.

Incision care

• Follow instructions from your health care provider about how to take care of your cut from surgery (incision). Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures) or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Managing pain, stiffness, and swelling

• If directed, apply ice to the injured area.
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.

Driving

• Do not drive for 24 hours if you received a sedative.
• Do not drive or operate heavy machinery while taking prescription pain medicine.
• Ask your health care provider when it is safe to drive.

Activity

• Rest at home as told by your health care provider.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do not lift anything that is heavier than 10 lb (4.5 kg) until your health care provider says that it is safe.
• For as long as told by your health care provider:
  • Do not do anything that causes pain.
  • Do not do any activities that require great strength and energy (are vigorous).

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were given an athletic support strap, wear it as told by your health care provider.
• Keep all follow-up appointments with your health care provider. This is important.

Contact a health care provider if:

• You have pain or swelling that is getting worse.
• You have more redness, swelling, or pain around your incision.
• You have fluid or blood coming from your incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from your incision.
• You have a fever.