Think Critically: Make an Informed Decision.

​Surgery (Varicocelectomy) Is Not a Cure​

• Only 6-14% of those who undergo surgery attain a benefit.
• 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.
• You do not return to a normal/healthy baseline post-surgery.

While the benefits of surgery are certain, the risks are very real. Be critical, ask lots of questions, and make an informed decision before committing to a permanent procedure that could injure you for life.

​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 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:

	Inscisional Surgery	Laparoscopic Surgery	Embolization (Radiology)
Pregnancy	​1 in 7	​1 in 7	1 in 17
Semen Improvement	20-40%	20-40%	10-35%
Testosterone	​None to mild improvement	​None to mild improvement	​None to mild improvement
​Pain Relief	​None to mild improvement	​None to mild improvement	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	Laparoscopic Surgery	Embolization (Radiology)
Pre-Operative Risks: Local Anesthetic	n/a	n/a	minimal risks
Pre-Operative Risks: ​General Anesthetic	Hypotension Hypoxia Arrhythmia	Hypotension Hypoxia Arrhythmia CO2 Embolus Acidosis Hypercarbia​	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	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	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 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	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	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

Science Sources

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