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Varicocele

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What is varicocele?
Varicocele is a group of enlarged veins near your testicles. It is more common on the left scrotum, but may occur on either side.

What causes varicocele?
It is not certain what causes varicocele. It is possible that a valve defect in the veins may be causing the veins to widen. Varicocele is not always visible but it does affect the blood flow in the testicles. If it becomes enlarged, it could cause the testicles to shrink and possibly reduce your fertility. Varicocele repair may improve fertility, but this is not guaranteed.

Symptoms of Varicocele
It usually shows no symptoms, but if it grows too large you may feel an uncomfortable heaviness in one side of your scrotum. Some people describe a dull ache as the day wears on.

Investigations to confirm diagnosis
Your Doctor can usually diagnose varicocele by feeling the scrotum. You may need a scrotal ultrasound to confirm the diagnosis.

Surgery
Surgery is usually recommended if the varicocele is causing discomfort or on occasions affecting fertility function.

What happens during the operation?
The operation is performed as a day case, which means you will usually stay for part of the day or all day. If it is performed under a general anaesthetic, you will be asleep during the procedure. If you have a spinal anaesthetic, you will be awake during the procedure, but you will have no sensation or pain below the waist.

The operation takes about 20-40 minutes. The varicocele is removed using open or laparoscopic (‘keyhole’) surgery, or embolisation. The surgeon will give you advice on which technique is suitable for you.

• Open surgery
A single cut is made, in your groin. The veins are identified tied and cut. This does not affect the healthy flow of blood to and from the area as alternative veins are left intact. The skin cut is closed
using dissolvable stitches.
• Laparoscopic (keyhole) surgery
A cut is made just below your belly button and two other small cuts 1mm for placement of narrow instruments. A tube – like telescopic camera is used to view the varicocele and specially designed
surgical instruments are used to clip and cut the vein. The skin cuts are closed using dissolvable stitches.
• Embolisation
This involves the blocking of the veins in the x-ray department. This is performed under a local anaesthetic, through a needle placed into your groin and wires are passed into the body to block these excess veins.

What to expect on discharge from hospital
You will need to wear supportive underwear to help relieve any discomfort and swelling, and to reduce your risk of developing a haematoma (bruising). Avoid wearing tight trousers for the first few days, jogging bottoms are best. The veins above your left testicle may become slightly more prominent initially after surgery. This should settle but may not disappear completely. You may experience some pain and discomfort, which can be relieved by taking painkillers as prescribed.

From the next day following the operation take a shower daily until the wound has healed. Do not do any heavy lifting or vigorous exercise for the first two week this includes sexual intercourse. You should be able to return to work after a few days depending on the nature of you work.

When should I seek help?
If you develop any of the following symptoms, contact your GP:
• Difficulty in passing urine
• Severe swelling or redness to the scrotum
• Bleeding or discharge from the wound
• Increasing pain or pain that cannot be controlled with pain killers
• A high temperature.

Further useful contacts:
01908 997004 – General Surgery, Colorectal, Breast, Urology Hub
Day Surgery Unit 01908 995468
Same Day Admission 01908996433
Ward 21 01908 996448
Pharmacy Medicine Information 01908 995733