Varicocele Treatment

What is Varicocele?

Varicocele is a dilatation of the veins of the pampiniform plexus, the veins that surround and drain the testicle. This dilatation is due to a reversal of venous flow. Instead of going from the periphery to the center, it goes from the center to the periphery due to a failure of the valves of the veins concerned. According to studies, about 15% of the male population is affected by varicocele, a disorder frequently diagnosed during puberty. Often, it is the left testicle that is affected, but it is also possible that both sides are affected, or in some cases, only the right side. The vast majority of studies acknowledge that varicocele is a cause of infertility. The largest study on this subject conducted by the World Health Organization in 24 countries showed that varicocele was much more prevalent in infertile individuals (25.4%). It is less common in the general population (11.7%). The guidelines of the main medico-scientific associations indicate that varicocele is the main cause of infertility in couples.

Preparing for Varicocele Treatment

Before Varicocele Treatment

Before treating varicocele, pre-operative examinations (EPO) will be carried out. The patient will undergo examinations such as blood tests, electrocardiogram, chest X-ray. He will also undergo an anesthetic examination and a urological assessment with a testicular ultrasound.

The Day of the Procedure

The patient will be admitted on the day of the procedure, usually as a day patient. He must therefore fast from midnight the previous night, eating a light dinner the previous night. The day before his admission, he will need to plan to shave from his navel to his thigh, paying particular attention to the hair in the groin and scrotum. Upon admission, the nursing staff will not only handle the administrative procedures, but will also ensure that the patient has followed the instructions previously given. Throughout his stay at the clinic, he will be accompanied by the nursing staff. Before going to the operating room, the patient will have to remove his dentures, watch, jewelry, piercings, etc., which he can retrieve upon his return.

What is the Price of Varicocele Treatment in Tunisia?

In Tunisia, the price of varicocele treatment varies depending on the technique used. Request a free personalized quote online on our website. You will be contacted by one of our advisors who will process your request and answer all your questions.

When Should Surgery Be Considered for Varicocele Treatment?

The main objective of surgery to treat idiopathic varicocele is to separate the dilated veins of the pampiniform plexus and redirect the venous blood flow leaving the testicles towards a network of unobstructed channels. This surgical intervention is recommended to treat varicocele in the following cases:

• Altered Sperm Quality: Sperm quality can be altered, ranging from a complete absence of sperm (azoospermia) caused by a halt in their maturation, to a slight modification of their concentration. While it is not guaranteed to improve sperm quality, it is recommended to treat this potential cause of infertility by having an assessment six months after the operation.
• Presence of Pain: Although relatively rare, the type of pain is, as already mentioned, very characteristic. However, it is necessary to verify, through a precise clinical evaluation, whether the pain is actually due to the varicocele or if it has other causes or concomitant pathologies;
• Aesthetic aspects, particularly in the case of large varicoceles;
• Absence of testicular growth, affected compared to the contralateral testicle in young adolescents;

What are the Different Types of Varicocele Treatment?

Various methods can be used to treat varicocele, but in particular two surgical approaches: classic surgery, also known as “open”, and laparoscopic surgery. In addition, drug treatment and embolization, a method that is gaining popularity, can also be considered.

Varicocele Surgery

Traditional surgery is one of the commonly used methods to treat varicocele. It can be performed under general or local anesthesia. The procedure involves making an incision of several centimeters in the skin, usually near the groin, to isolate the dilated veins of the pampiniform plexus. Depending on the case, the incision can be made at different locations such as the groin, abdomen, or even below the groin. In order to correctly isolate only the dilated veins, the surgeon uses a surgical microscope or an echodoppler. After isolating the dilated veins, the surgeon finishes by closing the incision with several stitches. At the end of the operation, there is an observation period of a few hours. This period is used to monitor the patient’s condition. After 2 days, the patient can already resume light daily activities. For heavier activities (such as sports), at least 2 weeks are necessary. Before resuming normal sexual activity, the operated patient must wait at least 3 weeks. After surgery, the patient may experience discomfort in the operated area. In such a situation, the doctor suggests taking analgesics such as paracetamol or ibuprofen to relieve the pain.

Laparoscopic Surgery to Treat Varicocele

Laparoscopic surgery for the treatment of varicocele involves the use of laparoscopy. Laparoscopy is a minimally invasive surgical technique. Thanks to this technique, the operating physician can access the abdominal cavity and the pelvic cavity of a patient without resorting to the large incisions required by traditional “open” surgery. For a better experience, laparoscopic surgery offers undeniable advantages. With incisions measuring only one centimeter, this technique allows the introduction of the necessary instruments to isolate the dilated veins of the pampiniform plexus. General anesthesia is required and the hospital stay generally does not exceed one day. Compared to those of classic surgery, the smaller incisions result in a slightly shorter recovery time, of about 10 to 14 days maximum. In addition, being less invasive, this operation allows a faster resumption of normal sexual activity.

Non-surgical Varicocele Treatment

Varicocele is a condition where the veins of the scrotum dilate, causing pain and a feeling of heaviness. It can also lead to decreased fertility in men. Although surgery is often recommended to treat varicocele, there are also non-surgical options. The clinical examination is the first step in diagnosing varicocele and assessing its severity. If the varicocele is mild, non-surgical treatment options may include managing pain with anti-inflammatory drugs, wearing supportive underwear, or adapting lifestyle habits such as adding physical exercise. If the varicocele is more serious, non-drug treatment should be considered in this case.

Percutaneous Embolization to Treat Varicocele

Percutaneous embolization to treat varicocele is an innovative technique performed by an interventional radiologist. Thanks to a screen connected to a digital fluoroscopy system, called angiography, the interventional radiologist is able to follow and control all the movements of the intervention material and the maneuvers performed inside the body. Thus, interventional radiology techniques, including embolization, practically never require the presence of a surgeon in the room. This is because neither skin incisions nor stitches are absolutely necessary at the end of the operation. Thanks to embolization, it is possible to treat the patient quickly, safely and extremely effectively. Embolization is just one of the many techniques used in interventional radiology. The latter is a medical branch that now allows the treatment of many organs and districts. More specifically, testicular varicocele embolization involves permanently or temporarily (depending on the needs) occluding a blood vessel, whether arterial or venous. In testicular varicoceles, embolization involves closing the spermatic vein in order to restore normal blood circulation from the testicle to the abdomen. The risks associated with testicular varicoceles are quite rare. These include local reactions of the testicle such as swelling, redness and pain, bleeding due to traumatic rupture of a vein (very rare), allergic reactions to the contrast medium, local anesthetic or sclerosing substance (very rare). Embolization has several advantages: identical or even superior effectiveness to traditional surgical treatment in terms of pain reduction and fertility increase, absence of surgical incisions and administration of general anesthesia, lower complication rates compared to traditional surgery, shorter hospitalization time compared to traditional surgery.

Contact and Quote Request for Varicocele Treatment

If you are considering varicocele treatment, do not hesitate to contact Tunisia Destination Santé. Our team is always at your disposal to assist and guide you through all the procedures. Do not hesitate to contact us for more information and to request a free, no-obligation quote.

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