COMPLICATIONS OF VARICOCELE SURGERY

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Varicoceles are a collection of veins (blood vessels) which become enlarged, inside the scrotum. They can be asymptomatic in some men, and cause pain and infertility in others. It’s estimated that varicoceles may play a role in up to 40% of couples dealing with infertility, defined as the inability to get pregnant after one year of unprotected sexual activity.

Any surgery has some risk, such as bleeding and/or infection at the incision site. But there are also some major complications specific to varicocele surgery that you should be aware of:

Varicocele recurrence can be due to incomplete blockage of the veins that are causing the varicocele. This may result in persistent symptoms and problems with fertility.
Hydrocele formation, or a collection of fluid in or around the scrotum, results from the disruption of the lymphatic flow. Hydroceles can become large and cause pressure in the scrotum. Rarely, one can rupture.
Testicular artery ligation, or the accidental tying off of the blood flow to the testicle, can occur with some surgical approaches. There are concerns that this may result in testicular atrophy and decreased testicular function, such as lower testosterone levels and decreased sperm quality.

TYPES OF SURGERY

There are several different types of surgical approaches for the treatment of varicoceles and each has its own risk of complications.

OPEN VARICOCELECTOMY requires an incision in the inguinal region (groin), in order to access the veins that are causing the varicocele and tie them off.

Recurrence risk
Hydrocele
Accidental testicular artery ligation risk or injury

LAPAROSCOPIC VARICOCELECTOMY involves several small incisions in the abdomen, for the insertion of a scope (camera) and surgical instruments, to access the veins that are causing the varicocele and tie them off.

Recurrence risk
Hydrocele risk
There is an increased risk of injury

FERTILITY

For some men, problems with fertility may be the main reason to seek varicocele treatment. Varicoceles are thought to cause lower sperm production and lower quality of sperm. Natural treatment of a varicocele may lead to increased sperm production and improved sperm quality. The effect of any procedure on fertility needs to be considered.

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