At Andrology Barcelona, we are a leading urology clinic committed to providing the best care and personalised treatment for varicocele, using the most advanced and effective techniques.
Varicocele: Causes, Diagnosis, and Effective Treatments
What is Varicocele?
Varicocele is a dilatation of the veins of the spermatic cord due to valvular malfunction, affecting approximately 15% of adult males. It occurs predominantly on the left side (90%), and the rest are bilateral (10%). Right unilaterals are extremely rare.
The most common symptoms are the appearance of a worm sac-like mass in the upper part of the scrotal sac and scrotal pain or discomfort after standing (less common).
Diagnosis of the different types of varicocele
Grade 0
Detectable only by ultrasound.
Grade I
Palpable with Valsalva manoeuvres.
Grade II
Palpable without valsalva (technique to assess blood circulation).
Grade III
Visible in the scrotum.
How do we treat varicocele at Andrology Barcelona?
Sclerotherapy or embolisation
Sclerotherapy or embolisation is a treatment in which the affected veins in the scrotum are blocked through a small incision. In embolisation, a radiologist inserts a small tube into a vein in the groin or neck and uses coils or a solution to block the testicular veins. The procedure takes about an hour and has a short recovery period.
High retroperitoneal varicocelectomy (open or laparoscopic)
The procedure for this surgery involves tying off (closing) the affected main vein in the abdomen. It can be performed open, with a larger incision, or laparoscopically, using small incisions and a camera to guide the surgeon.
Subinguinal microsurgical varicocelectomy (low)
This technique uses microsurgical tools and a microscope to selectively ligate the affected veins at the groin level. It is the most recommended method because it is less likely to result in varicocele recurrence and offers better results in semen quality and pregnancy rates.
Advantages of microsurgical or subinguinal treatment
- Improved fertility: Surgery can improve semen quality and the chances of pregnancy.
- Pain reduction: Although controversial, it may relieve chronic pain in some cases.
- Recovery of testicular size: In adolescents, the affected testicle may reach the expected size.
- Rapid recovery: The procedures have short recovery times and allow for a quick return to daily activities.
Frequently asked questions about varicocele treatment
Do all varicoceles need to be treated?
No, treatment is recommended primarily for men with infertility, testicular asymmetry or chronic pain not relieved by analgesics.
How is the recovery after surgery?
Pain is usually mild and may last for several days or weeks. Painkillers can be prescribed and physical activity can be resumed within two weeks.
What are the risks of varicocele surgery?
All surgery has its risks, although in skilled hands these are reduced. Risks include fluid build-up around the testicles (hydrocele), recurrence of varicoceles, infection, damage to an artery, chronic testicular pain and blood collection around the testicle (haematoma).
Do you need more information about varicocele?
At Andrology Barcelona we are experts in the microsurgical technique for the treatment of varicocele. Together we will find the most appropriate solution for you.