Urologist
What is varicocele and how does it lead to infertility?
Varicocele is the enlargement of the testicular veins. The testicular veins are about 1-2 mm thick; they extend upward for about 20-30 cm and open into the body's main venous system. The long distance the veins travel and gravity make it difficult for blood to flow upward. As a result, in some men, blood in the testicular veins cannot be transported upward, and even blood from the main venous system can flow into the testicles, causing blood to pool. This blood pooling in the testicle increases the testicular temperature and leads to the accumulation of waste products that should be expelled from the testicle. This condition can cause testicular pain and infertility by impairing sperm production.
How can varicocele be treated?
There is no medical treatment for varicocele. The only treatment is surgical. During surgery, the enlarged veins are ligated to prevent blood pooling in the testicle.
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The testicular arteries, lymphatic vessels, and veins are located very close to each other and are very thin, making it difficult to separate them during surgery with the naked eye. If the surgery is performed without a microscope, the risk of damage to the arteries and lymphatic vessels increases. To avoid this unwanted outcome, the procedure should be done under a microscope.
Why should varicocele surgery be performed under a microscope?
The surgery is performed through a 3-4 cm incision at the groin. After the incision, the area where the testicular veins are located is accessed, and under the microscope, the enlarged veins are ligated while preserving the arteries and lymphatic vessels. This surgery is called microscopic varicocelectomy. The success rate of microscopic varicocelectomy is over 90%.
How successful is varicocele surgery?
Approximately 6 months after surgery, a 70-80% increase in sperm count and motility is observed.
