Learn More! Make an Informed Decision.
Surgery (Varicocelectomy) Is Not a Cure
- Only 6-14% of those who undergo surgery attain a fertility benefit
- Surgery may or may not be effective for pain relief
- The long-term outcomes of surgery are not studied enough and are unknown
- Cutting out swollen veins is not curing them, and it does Not address the real problem
- Surgical results are questionable
- Surgery is a high risk procedure
- A successful operation does not mean that you have recovered
Benefits of Varicocelectomy & Embolization
The reported 20-40% improvement in semen parameters is not associated with successful pregnancy. The best results for surgery state that for every 7 people who undergo surgery, only 1 additional pregnancy will be attained. You're more likely to suffer from negative side-effects than to have any benefit from varicocele surgery. The following tables assess the real benefits and risks of surgery:
Incisional Surgery Benefits
- Pregnancy: 1 in 7 (14%)
- Semen Improvement: 20-40%
- Testosterone: None to mild improvement
- Pain Relief: None, or 48% - 90% improvement
Laparoscopic Surgery Benefits
- Pregnancy: 1 in 7 (14%)
- Semen Improvement: 20-40%
- Testosterone: None to mild improvement
- Pain Relief: None, or 48% - 90% improvement
Embolization (Radiology) Benefits
- Pregnancy: 1 in 17 (4%)
- Semen Improvement: 10-35%
- Testosterone: None to mild improvement
- Pain Relief: None to mild improvement
The Risks of Varicocele Surgery & Embolization
There are many severe risks associated with varicocele surgery. I advise that you carefully consider the pros & cons before making your decision. You can also learn more about how surgery is likely not effective at all.
Incisional Surgery Risks
- Pre-Operative Risks: Local Anesthetic: N/A
- Pre-Operative Risks: General Anesthetic:
- Hypotension
- Hypoxia
- Arrhythmia
- Intra-Operative Risks:
- Bleeding
- Injury to the pubic arteries
- Arterial ligation
- Nerve damage
- Failure at attempt (1%-5%)
- Loss of testicle on side of the surgery (1%)
- Injury to a nerves in the pubic area
- Post-Operative Risks:
- Hematoma
- Shrinking of the testicle on the side of the surgery (1%)
- Hydrocele (5-10%)
- Persistent/recurrent varicocele (5-10%)
- Pain pills (2-6 weeks)
- Genitofemoral Nerve Injury
- Scrotal Emphysema
- Umbilical Granulomas
- Infection at site of surgery (1%)
- Deep venous thrombosis (DVT) (5%)
- Pulmonary embolus (PE) (1%)
- Onset of pain where there was none before (1%)
- Failure to relieve pain (15%)
- Continued infertility (86%)
- Decreased fertility
- Permanent scarring at incision site
- Lowered testosterone levels
Laparoscopic Surgery Risks
- Pre-Operative Risks: Local Anesthetic: N/A
- Pre-Operative Risks: General Anesthetic:
- Hypotension
- Hypoxia
- Arrhythmia
- CO2 Embolus
- Acidosis
- Hypercarbia
- Intra-Operative Risks:
- Injury to the pubic arteries
- Trocar injury (bowel, bladder)
- Preperitoneal insufflation
- Failure at attempt (1%-5%)
- Loss of testicle on side of the surgery (1%)
- Injury to a nerves in the pubic area
- Post-Operative Risks:
- Unrecognized bowel injury
- Omental eviscertain
- Abdominal wall emphysema (4.5%)
- Pneumoscrotum (2.6%)
- Deep venous thrombosis (DVT) (5%)
- Hydrocele (5-15%)
- Persistent/recurrent varicocele (10-25%)
- Pain pills (2-6 weeks)
- Infection at site of surgery (1%)
- Shrinking of the testicle on the side of the surgery (1%)
- Pulmonary embolus (PE) (1%)
- Onset of pain where there was none before (1%)
- Failure to relieve pain (15%)
- Continued infertility (86%)
- Decreased fertility
- Permanent scarring at incision site
- Lowered testosterone levels
Embolization (Radiology) Risks
- Pre-Operative Risks: Local Anesthetic: Minimal risks
- Pre-Operative Risks: General Anesthetic:
- Hypotension
- Hypoxia
- Arrhythmia
- Intra-Operative Risks:
- Adverse reaction to contrast (x-ray) dye
- Vascular allergy
- X-ray radiation exposure
- Bleeding from vein perforation (rupture) (1%)
- Thrombosis of major veins
- Failure at attempt (15-30%)
- Post-Operative Risks:
- Hematoma (2%)
- Coil migration resulting in testicular loss (1%)
- Hydrocele (10-20%)
- Persistent/recurrent varicocele (10-30%)
- Pain pills (2 days - 1 week)
- Continued infertility (94%)
- Failure to relieve pain
- Onset of pain where there was none before
- Decreased fertility
- Lowered testosterone levels
Watch: Varicocele Surgery (Full)
Science Sources
- In men with varicocele, does surgery improve fertility? Ashleigh Wilkerson-Mike Linder-Carrie Gray-Nick Prylinski-Bilal Islam - https://mospace.umsystem.edu/xmlui/handle/10355/61604, 2017
- Parrilli, Alejandra; Roberti, Agnese; Escolino, Maria; Esposito, Ciro (2016-10). "Surgical approaches for varicocele in pediatric patient".Translational Pediatrics. 5 (4): 227–232. ISSN 2224-4344. PMC 5107384 . PMID 27867844.doi:10.21037/tp.2016.09.11.
- Cochetti, Giovanni; Barillaro, Francesco; Cottini, Emanuele; D’Amico, Francesco; Pansadoro, Alberto; Pohja, Solajd; Boni, Andrea; Cirocchi, Roberto; Grassi, Veronica (2015-04-09). "Pneumoscrotum: report of two different cases and review of the literature". Therapeutics and Clinical Risk Management. 11: 581–587. ISSN 1176-6336.PMC 4399391 . PMID 25914539.
- Marmar, Joel L (2016). "The evolution and refinements of varicocele surgery". Asian Journal of Andrology. 18 (2): 171–178. ISSN 10
- 08-682X.PMC 4770481 . PMID 26732111. doi:10.4103/1008-682X.170866.
- "Six years’ experience of laparoscopic varicocelectomy using bipolar electrosurgery and its effect on semen parameters". Urology Journal. 13 (4). 2016-08-25.
- "Deep vein thrombosis and intraperitoneal hemorrhage after thrombolysis: rare complication of laparoscopic varicocelectomy". Int J Clin Exp Med 2016;9(10):20319-20323
- Chi, Amanda C.; Hairston, John C. (2015-05-01). "Acute Right Varicocele: A Clue to Congenital Vascular Anomaly". Urology. 85 (5): e39–e40.doi:10.1016/j.urology.2015.02.005.
- "Treatment of male varicoceles by transcatheter polidocanol foam sclerotherapy: evaluation of clinical success, complications, and patients' satisfaction with regard to alternative techniques - ProQuest". search.proquest.com. Retrieved2017-07-04.
- Halpern, Joshua; Mittal, Sameer; Pereira, Keith; Bhatia, Shivank; Ramasamy, Ranjith (2016)."Percutaneous embolization of varicocele: technique, indications, relative contraindications, and complications". Asian Journal of Andrology. 18 (2): 234–238. ISSN 1008-682X. PMC 4770492 .PMID 26658060. doi:10.4103/1008-682X.169985.
- Zampieri, N.; Castellani, R. L.; Zampieri, G.; Camoglio, F. S. (2014-10-01). "PS-067 Treatment Of Varicocele In Paediatric Patients With Contraindication For Open Surgery With Transfemoral Retrograde Sclero-embolization Under Local Anaesthesia".Archives of Disease in Childhood. 99 (Suppl 2): A136–A136. ISSN 0003-9888. doi:10.1136/archdischild-2014-307384.363.
- Favard, Nicolas; Moulin, Morgan; Fauque, Patricia; Bertaut, Aurélie; Favelier, Sylvain; Estivalet, Louis; Michel, Frédéric; Cormier, Luc; Sagot, Paul (2015-12). "Comparison of three different embolic materials for varicocele embolization: retrospective study of tolerance, radiation and recurrence rate".Quantitative Imaging in Medicine and Surgery. 5 (6): 806–814. ISSN 2223-4292. PMC 4700243 .PMID 26807362. doi:10.3978/j.issn.2223-4292.2015.10.10.
- Ramasamy, Ranjith (2014-06-02)."Percutaneous embolization: a viable treatment option for varicocele". Basic and Clinical Andrology. 24: 10.ISSN 2051-4190. PMC 4345412 . PMID 25741442.doi:10.1186/2051-4190-24-10.
- Choi, Woo Suk; Kim, Soo Woong (2013-04-01). "Current Issues in Varicocele Management: a Review". The World Journal of Men's Health. 31 (1).ISSN 2287-4208. PMC 3640148 . PMID 23658861.doi:10.5534/wjmh.2013.31.1.12.
- Godbole, Prasad P.; Wilcox, Duncan T.; Koyle, Martin A. (2015-07-20). Pediatric Urology: Surgical Complications and Management. John Wiley & Sons.ISBN 9781118473313.
- Kandemir, E., Sezer, A., & Bozkurt, M. (2023). Effect of physical activity level and occupation on resolution of pain after varicocelectomy: A prospective clinical study. Revista Internacional De Andrologia, 21(4), 100372. https://doi.org/10.1016/j.androl.2023.100372