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Important Questions to Ask Before Committing to Varicocele Surgery

22/3/2017

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The Right to Informed Consent

You have the Right to Informed Consent. Ask the right questions, make an informed decision!

Ask Yourself

Why are you having surgery? Do you need to have surgery? What are the alternatives?

Benefits of Surgery?

What is the Number Needed to Treat (NNT) for varicocelectomy?
Is surgery effective for fertility treatment? How effective? Does it lead to improvement in pregnancy rates? In what percent of people (or NNT)?
Is surgery effective for pain treatment? How effective? In what percent of people (or NNT)?
Is surgery effective for improving testosterone? Does this lead to any real benefits? Is this an effective method for improving virility? How effective? In what percent of people (or NNT)?
What is the definition of a successful operation?

Surgical Risks

What percent of people who undergo surgery experience symptoms?
What symptoms do people experience? At what rate (percentage) for each symptom? How long will each symptom last?
Any potential permanent symptoms? How severe? What rate does it occur?
What is the definition of a failed operation?

Your Surgeon's Skill & Results

What is your definition of a successful procedure (e.g. just varicose veins removed vs. tangible improvement of semen parameters, pregnancy rates, testosterone, pain reduction, etc.)
What percent of your clients have had a successful procedure? What percent have reported a successful procedure?
What is your definition of a failed procedure? What percent of your clients have developed negative side-effects? What percent have been surveyed or have reported?

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AVOID EMBOLIZATION

20/3/2017

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ONLY 1 in 17 people who undergo embolization for varicocele receive a benefit... ihttp://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802013000100067

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Why You Should Avoid Varicocele Surgery

20/3/2017

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The Number Needed to Treat (NNT) for varicocelectomy is 7. Meaning that for every 7 people undergo surgery, only one person will benefit with a successful pregnancy [26]. So, the 30-60% semen improvement you see is very misleading. Now, mix this is the

Blood clots in the legs, also known as deep venous thrombosis (DVT). A DVT can travel to the lungs, which is known as a pulmonary embolus (PE). DVT is reported in less than 5% of patients, and PE is reported in less than 1%.
Infection at the site of the surgery. This is reported by less than 1% of patients.
Shrinking of the testicle on the side of the surgery. This is reported in less than 1% of patients.
Constant buildup of fluid around the testicle, also known as a hydrocele. This is reported in less than 1% patients.
Return of the varicocele. This is reported by less than 5% of patients.
Failure to relieve pain. Up to 15% of patients will have no relief, or inadequate relief, of pain after a subinguinal varicocelectomy.
Onset of pain. In rare cases (less than 1%), patients who do not have pain will develop pain at a surgical site.
Continued infertility. While some couples do get pregnant more readily after varicocele surgery, not all couples will benefit from surgery.

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Varicocele Treatment Without Surgery

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Important Questions to Ask Before Committing to Varicocele Surgery

The Right to Informed Consent

Ask Yourself

Benefits of Surgery?

Surgical Risks

Your Surgeon's Skill & Results

AVOID EMBOLIZATION

Why You Should Avoid Varicocele Surgery

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