Surgical treatment of varicocele in Kharkov

Varicocele is a testicle varicosity. Pathology is one of the most common diseases of the male reproductive system. Testicle varicocele is diagnosed in about 15% of males and can occur at any age. In children, the pathology is predominantly congenital. Varicocele in adolescents develops during puberty (14-15 years).

Pathology leads to a blood supply disturbance to the testicle and its gradual decrease in size (atrophy). And since sperm cells are formed in the testicle, this negatively affects reproductive function. In about 40% of men, varicocele causes infertility.

The most commonly diagnosed left-sided varicocele (97-98% of cases). This is due to the peculiarities of the anatomical structure of testicle and its veins. The vein of the left testicle flows into the left renal vein at a right angle, which hinders the blood outflow from the gonad and contributes to the development of varicose veins. Varicocele of the right testicle is diagnosed in about 3-7% of all cases of the disease. Bilateral varicocele is detected in 2-11% of men.

There are four grade of varicocele development:

1. 0 grade varicocele can be detected only by ultrasound of vessels.
2. 1 grade varicocele is detected during a patient’s straining in a standing position, and in a calm state the dilated veins of the testicle are not visible.
3. 2 grade varicocele is characterized by the presence of dilated veins under the scrotum skin, which are easily palpable, but not yet visible to the naked eye.
4. 3 grade varicocele is accompanied by scrotum enlargement and dropping from the side of the affected testicle, as well as the appearance of bulging, twisting veins under the skin.

At an early stage, the pathology develops asymptomatically. The clinical manifestations of testicular varicose veins occur as the disease progresses. The main symptoms of varicocele include:

• enlargement of the scrotum;
• dropping of one half of the scrotum;
• testicle reduction;
• discomfort in the groin area. Pain with varicocele can be mild or intense. Painful sensations intensify during walking, exercise and sexual intercourse.

The most serious complication of varicocele is male infertility caused by blood stagnation in the testicle veins and increase in its temperature. For the normal development of sperm, the temperature in the gonads should be 2-3 degrees below body temperature. Other complications of varicocele include a enlargement in testicular size and hypogonadism (a decrease in testosterone levels). A decrease in the production of the main male sex hormone is fraught with erectile dysfunction, decrease in sexual vigor and increase in the percentage of body fat.

Causes of varicocele occurrence

The main causes of varicocele development include:

• insufficiency of valves in the testicular vein or their congenital absence;
• high blood pressure in the scrotum and abdomen;
• weakness of the vein walls;
• reverse flow of blood into the vein;
• prolapse of the kidney;
• narrowing of the renal artery.

Laparoscopic treatment of varicocele

The only treatment for 2-3 grade varicose veins is surgery. The goal of varicocele surgery is to restore normal blood flow to the affected testicle by ligating the dilated vein and redirecting blood flow through healthy vessels.

The medical center “ON Clinic Kharkov” uses the following minimally invasive surgical techniques for treating varicocele:

• laparoscopic varicocelectomy is a ligation of the spermatic vein through three small punctures in the abdomen. In the first puncture in the umbilical ring, a laparoscope is installed; it is a thin long probe with illumination and a built-in video camera, an enlarged image from which is displayed on the monitor. In the remaining 2 punctures, special surgical instruments are inserted the doctor uses to bandage the vein. Laparoscopy for varicocele is one of the priority types of surgical intervention, as it is characterized by low trauma, absence of postoperative scars and a short recovery period.
• Marmar operation is an open microsurgical intervention. Surgeon makes a small incision (2 cm) above the scrotum, separates the varicose veins of the spermatic cord and ties them under a microscope. Then a cosmetic suture is applied to the wound.

Laparoscopic varicocelectomy is performed under inhalation anesthesia - a patient is immersed in a drug-induced sleep. During Marmar operation, intravenous anesthesia is used. The duration of operation is from 30 minutes to an hour in average. After operation completion, a patient is transferred to the ward where he/she stays from 2-3 hours to a day, and then is discharged home.

Preparation for laparoscopic varicocelectomy

The first stage of preparation for laparoscopic varicocelectomy is consultation and examination by urologist. Then the doctor directs the patient for additional diagnostic tests. At the second appointment after examining the test results, the urologist appoints the date of the operation. In the evening before and on the day of the operation, the patient must not eat, as well as he must not drink two hours before the operation

Make appointment for a consultation by urologist at the medical center “ON Clinic Kharkov”. Leave a request on the site at any convenient time or call the specified phone number. Our administrators will answer all your questions.