Laparoscopic Varicocelectomy

Varicocelectomy is surgery to repair a varicocele. A varicocele is swelling of veins in the scrotum. This swelling is due to blood backing up in the veins. A varicocele can cause pain or a heavy feeling in the scrotum but is usually painless. It can also cause problems with fertility. During the surgery, the swollen veins are cut and the ends are closed off. Other veins in the groin area then take over carrying the blood supply. The surgery may be done with a technique called laparoscopy or through open surgery. During laparoscopy, a thin, lighted tube called a laparoscope (scope) is used. The scope allows the doctor to work through a few small incisions. This sheet explains the surgery.

Front view of male outline showing incision sites for laparoscopic varicocelectomy.

Front view of penis and testicles showing varicocele.

Preparing for surgery

Prepare for the surgery as you’ve been told. In addition:

  • Tell your doctor about all medicines you take. This includes herbs and other supplements. It also includes any blood thinners, such as warfarin, clopidogrel, or daily aspirin. You may need to stop taking some or all of them before surgery, as instructed by your doctor.

  • Do not eat or drink during the 8 hours before your surgery. This includes coffee, water, gum, and mints. (If you have been instructed to take medication, take them with a small sip of water.)

The day of surgery

This surgery takes 2 to 3 hours. You’ll likely go home the same day.

Before the surgery begins:

  • An IV line is put into a vein in your arm or hand. This supplies fluids and medicine (such as antibiotics).

  • You may receive a medicine to prevent blood clots.

  • To keep you free of pain during the surgery, you’re given general anesthesia. This medicine puts you into a state like deep sleep through the surgery. A tube may be inserted into your throat to help you breathe.

  • A thin tube (catheter) is placed in your bladder to drain urine.

During the surgery:

  • The doctor makes a few small incisions in the abdomen.

  • The scope is placed through one of the incisions. It sends live pictures of the inside of the abdomen to a video screen. 

  • The abdomen is filled with gas. This makes space for the doctor to see and work.

  • Using tools placed through the other incisions, the swollen veins are cut. The ends may be sealed with tiny clips. Or the ends may be cauterized.

  • When the surgery is complete, all tools are removed. The incisions are closed with stitches or staples.

Note: The doctor will begin with laparoscopy. But he or she may need to change to open surgery for safety reasons. Open surgery is done using an incision in the abdomen or the groin. You’ll be told more about this possibility before surgery.

After the surgery

You’ll be taken to a recovery room to rest until the anesthesia wears off. You may feel sleepy and nauseated. If a breathing tube was used, your throat might be sore at first. You’ll be given medicines to manage any pain. The catheter will be removed from your bladder. When you’re ready to go home, you’ll be released to an adult family member or friend.

Recovering at home

Have someone help you at home as your healing begins. Follow all the instructions you’ve been given. Make sure to:

  • Take all medicines as directed.

  • Care for your incisions as instructed.

  • Apply ice or a cold compress to the scrotum for 10 minutes at a time for the first 48 hours. This helps reduce swelling.

  • Follow your doctor’s guidelines for showering. Avoid swimming, bathing, using a hot tub, and other activities that cause the incision to be covered with water until your doctor says it’s OK.

  • Avoid sex for 1 to 2 weeks.

  • Avoid heavy lifting and other strenuous activities as directed.

  • Avoid driving until your doctor says it’s OK. Do not drive if you’re taking medicines that make you drowsy or sleepy.

  • Avoid straining to pass stool. If needed, take stool softeners as directed by your doctor.

When should I call my doctor?

Call the doctor if you have any of the following:

  • Chest pain or trouble breathing (call 911)

  • Fever of 100.4°F (38.0°C) or higher

  • Symptoms of infection at an incision site, such as increased redness or swelling, warmth, worsening pain, or foul-smelling drainage

  • Pain that cannot be controlled with medicines

  • Swelling in the scrotum that doesn’t go away

  • Trouble passing urine

  • Nausea or vomiting that won’t go away

  • Pain or swelling in the legs

Follow-up care

You’ll have follow-up visits so your doctor can check how well you’re healing. If your stitches or staples need to be removed, this will likely be done in 7 days. If you’re concerned about your fertility, a sample of your semen can be checked in about 3 to 4 months. This helps see if the number and quality of your sperm have improved.

Risks and complications

Risks and possible complications

  • Infection

  • Bleeding, blood clots

  • Return of the varicocele

  • Failure to restore fertility

  • Fluid around a testicle (hydrocele)

  • Shrinking (atrophy) of a testicle

  • Damage to nearby nerves, blood vessels, or organs (including the intestine)

  • Temporary decrease in sperm count

  • Chronic pain

  • Risks of anesthesia (the anesthesiologist will discuss these with you)


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