Varicocelectomy is Not a Cure.
Learn the facts. Make an Informed Decision.
Mr. Daniel Johnson, B.Sc.
NNT of Varicocelectomy & Embolization
The Benefits in Number Needed to Treat (NNT) stands for how many people need to be treated before one benefit is attained. For example, the NNT for surgery is 7, meaning that for every 7 men who undergo the procedure, 1 additional pregnancy will be attained. The NNT for pain relief is not established, nor is the NNT for improving testosterone is not established.
Note that just because your sperm count increases by for example 70%, that doesn't necessarily translate to a successful pregnancy.
But, notice what the NNT this does not say: It does not say that the swelling will be gone. It does not say that you will not develop chronic pain after the procedure. It does not say anything about the harms of the procedure.
NNH of Varicocelectomy & Embolization
So, we also need to educate ourselves about the Number Needed to Harm (NNH). The NNH stands for how many people need to be treated before one harm occurs. For example, for about every 3 men with right-sided varicocele who undergo embolization, 1 redevelops varicocele. Another example, for every 100 men who undergo microsurgery, 1 testicular loss occurs due to arterial damage.
Notice that there still isn’t a real discussion about the most important thing: Alternatives! What other, non-invasive alternatives do you have? How effective are those alternatives in contrasted to surgery and embolization? What are the NNTs? What are the NNHs? Are there more effective alternatives? Especially, if you’re looking for improving your fertility, are there alternative that are both safer and more effective? For pain relief, and restoring normal testosterone too; what are the alternatives?
Why You Must Demand More Answers!
So, you see, knowing about the NNT, helps you ask very specific questions. Don’t just believe “high rate of success”. Ask questions! “High rate of success, for what specific benefit?” “What is the NNT to attain that benefit?” “How strong is the evidence supporting each specific benefit?” “What are the associated harms, and my likelihood of suffering from one of them?” “Are there any alternative treatment methods, especially non-invasive, or lifestyle related that I need to know about?”
Your Right to Informed Consent:
Truly, learning about and asking about the NNT and NNH is about practicing your right to informed consent. But, the real problem is that most doctors are so rushed for time that they will almost never give you the complete picture. But, it’s time that we demand not more from our medical practitioners. It’s time that we do our own research when it comes to potentially harmful procedures. It is time that we begin to practice our right to informed consent.
Varicocele: NNTs Table
Varicocele: NNHs Table for Varicocelectomy
Varicocele: NNHs Table for Embolization
It seems like doctors lose all rationality as soon as you're diagnosed with varicocele. They blame your condition (varicocele) on unknown factors, and any symptoms that you may have (e.g. infertility, low testosterone, testicular pain, hypogonadism, etc.) on your varicocele. Now, they give you one of two options:
Oh, and if you have pain, they might recommend some pain killers.
If you get "lucky" and get a really "good" doctor, he might recommend a scrotal supporter.
Seems like all rationality and the last 1,000 years of medical and scientific advancement just went right out the window.
Your doctor is likely setting you up for failure with all of these strategies!
✗ Wait & See If Your Varicocele or Symptoms Will Improve
As it turns out, when it comes to varicocele, the worst thing that you can do is: Wait! Both varicocele grade and severity increase with time if left untreated. So, telling you to "do nothing" and "wait and see" is the same as telling you that there is nothing that can be done to improve your condition other than to wait until it is bad enough for you to be forced to have surgery. Yep, setting you up to fail.
✓ Don't Do "Nothing"!
Don't wait for surgery. If you have a varicocele, there is a lot that you can do. Sign up for the 100 Free Varicocele Treatment Tips & see for yourself.
✗ Take Pain Killers
If you have varicocele pain, it is pretty normal for your doctor to recommend temporary pain relief medication. But, the problem is that these medications typically have the symptom of worsening digestive health. Poor digestive health is a varicocele risk factor. So, when get off these medications, when you get off them, your symptoms typically worsen!
✓ Improve Digestive & Bowel Health
Constipation, poor digestive health, irregular bowel movements, and bloating all varicocele risk factors. They exacerbate the Nutcracker Syndrome. So, if you have any of those risk factors, you'll notice improvement of your varicocele and symptoms by correcting them!
✗ Scrotal Supporters
I find this one really backwards. Doctors treat testicular varicocele as if it is a varicose veins in the legs, and recommend that you wear compressive undergarments to help improve testicular blood circulation. While it sounds like it makes sense at first, it completely ignores that the testicles are completely different than the legs... Sure, compression helps, but, normal scrotal support underwear overheats the testicles, and at the same time prevent the testicles from dropping down to cool. Oops, they missed the only reason why you have a scrotum.
✓ Proper Scrotal Support Underwear
Proper scrotal support underwear takes into consideration that your testicles need both scrotal support and maximum cooling. Avoid generic brands. Get STUD Varicocele Therapeutic Underwear.
✗ Surgery or Embolization?
Which is better: Embolization or varicocelectomy?
✓ Avoid Both!
Both surgery & embolization are bad options! Don't fall for the surgery vs embolization marketing tactic. Embolization is typically sold as a "non-surgical" alternative to varicocelectomy (surgery), with only a small "small incision", "no general anaesthetic", and on an "out-patient bases". Hmmm, that sounds great, right?
Hmmm, I think we forgot something... Oh yeah, Results! Will it treat your varicocele? Will it improve your fertility and help you attain successful pregnancy? Will it cure your pain? Well, as it turns out the answer to all of these is "likely no", and "we're not certain". The science is really lacking on embolization. Surgery is likely also fairly ineffective for pain relief and improving pregnancy rates. The results for both surgery and embolization are uncertain.
But, you know what is certain? The risks of both surgery & embolization! Comprehensive: Surgery & Embolization Risks & Benefits >
✗ We Don't Know What Causes Varicocele
Genetically faulty valves? Nutcracker syndrome? We just don't know what causes varicocele! There is nothing that you can do, but blame your infertility on varicocele. Blame your testicular pain on varicocele. Blame your hypogonadism on varicocele. Forget your shitty lifestyle: The fact that you sit 8-12 hours a day on a cushion chair that traps heat for work, or the fact that you've inactive, or that you chain smoke. No! Forget about all of that, and just focus on varicocele--that's the real problem here. And, there is NOTHING that you can do about it.
✓ There is a Lot That You Can Do!
Actually, when it comes to varicocele, infertility, testicular pain, etc. there is a lot that you can and should be doing! Here is a quick and easy example: When it comes to infertility, even if caused by "varicocele", is there really nothing that you can do? What about being more active? What about cooling down your testicles? What about improving your diet and managing your stress?
There are many specific varicocele lifestyle risk factors, and many at home varicocele natural treatments. Now, again, just sign up for the 100 Free Varicocele Treatment Tips and see for yourself. Or, start with one of my Varicocele Natural Treatment Programs now & get varicocele under control!
Remember: When it comes to varicocele, the worst thing that you can do is "Nothing", and really, there is a lot that you can do! So, do something!
✓ Don't Do "Nothing"!
✓ Improve your Lifestyle Risk Factors
✓ Wear Proper Cooling Scrotal Support Underwear
✓ If Possible, Avoid Both Surgery & Embolization
✓ There is a Lot That You Can Do!
Well, both are bad options. Don't fall for the surgery vs embolization marketing tactic. Embolization is typically sold as a "non-surgical" alternative to varicocelectomy, with only a small "small incision", "no general anaesthetic", and on an "out-patient bases". Hmmm, that sounds great, right?
Hmmm, I think we forgot something... Oh yeah, Results! Will it treat your varicocele? Will it improve your fertility and help you attain successful pregnancy? Will it cure your pain? Well, as it turns out the answer to all of these is "likely no", and "we're not certain". The science is really lacking on embolization.
But, you know what is certain? The risks of embolization.
Embolization is a radiological procedure, that means x-ray exposure, and x-ray dye injection to help visualize the veins. It also has a high varicocele recurrence rate--up to 35% for right-sided varicoceles. 10-35% chance of hydrocele formation. Oh and my favorite one: Coil migration resulting in testicular loss... And many more risks.
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