Depending on the severity of the varicocele, there are various treatments that may be offered. Milder cases may be helped through non-surgical methods while more severe cases may require surgery.
In very mild cases with no associated symptoms present, use of an athletic support or close-fitting underwear can provide support to the scrotum, thereby helping to relieve the problem.
For some men, embolization may help to ease the pressure placed on the veins while returning blood flow through the veins back to normal. In this procedure, a small catheter is used to insert tiny coils into the affected veins, thereby blocking the flow of blood.
Using venography, the doctor then locates the enlarged veins through x-ray, which also helps to guide the catheter. Once the coils are in place, the pressure on the veins is relieved helping to minimize the dilation and restore normal circulation again.
While some anesthetic is used during the procedure, the male should not be knocked completely unconsciousness. Men can usually return to their normal activities within 48 hours of the procedure.
Solving it Surgically
In more advanced cases, specifically those men who have pain, testicular damage due to varicocele or are experiencing infertility, surgery may be advised. The most common type of surgery is varicocelectomy, whereby the affected veins are tied off and blood flow is re-routed through unaffected veins.
These are two common methods used to achieve this result.
A more invasive procedure, a surgical ligation involves making an incision in order to cut and tie off the affected veins while re-routing blood to circulate through veins not affected by varicocele. During the procedure, local or general anesthetic will be given and an incision, two to three inches in length, will be made, usually in the groin but occasionally in the lower abdomen.
The surgeon will locate the varicoceles veins visually, without the aid of other equipment. This surgery may be done on an out- or in-patient basis. Men who receive this type of surgery should avoid strenuous activities for six weeks but will be able to return to light activities within a week of the surgery.
Regarded as a less invasive type of surgery, laparoscopy involves the use of microscopic surgical instruments to perform the procedure. Once a small incision has been made in the abdomen, a camera is inserted to locate the affected veins.
When the varicocele has been found, the surgeon will insert the necessary instruments to tie off the affected veins and re-route the blood. In addition to being less invasive than surgical ligation, laparoscopy involves a much shorter recovery time, with most men able to resume normal activities within two days. However, this type of surgery does increase the risk of damage occurring to the abdominal organs.
While surgery is often successful at clearing up the problem, about 5% of men will experience a recurrence of varicocele.
Pregnancy After Treatment
A semen analysis performed shortly after surgery may indicate a slight improvement in sperm quality. However, male fertility does not immediately return to its full capacity after surgery, taking as much as three months or more to be restored.
For this reason, most fertility specialists will perform a semen analysis three to four months after the procedure and then again six months after the surgery to evaluate a man’s fertility.
Between 43% and 50% of men who undergo treatment for varicocele will be able to conceive a child with their partner within the first year.