Varicocoele repair

A varicocoele repair (also called a varicocoele ligation or a varicocoelectomy) is an operation to ligate (tie off) the testicular veins where they enter your abdomen. This stops blood from flowing the wrong way and pooling in the testicular veins.

Varicocoele repair is performed in hospital under a general anaesthetic (completely asleep). It is performed as a minimally invasive ‘keyhole’ procedure using laparoscopic or robotic surgical equipment.

We inflated your abdominal cavity with carbon dioxide gas to create space to perform the operation. We make 3 – 5 keyhole incisions in your abdomen through which we insert the laparoscopic/robotic surgical instruments.

The testicular veins are located and clipped or cauterised.

After a varicocoele repair, your body will divert blood away from your testicle via an alternative vein, so the blood supply to your testicle will not be affected.

The operation is usually performed as day surgery – you can go home on the same day if you are accompanied by a responsible adult. Sometimes a one-night hospital stay is required.

You will need to avoid strenuous exercise, cycling, and heavy lifting for at least three-four weeks after the operation.

You will not be able to swim for two weeks after the operation.

You can usually start driving two to four days after the operation.

You can resume sexual activity when you feel comfortable doing so. For most men this will be approximately two weeks after the operation.

Varicocoele repair successfully stops blood pooling in the testicular veins in 90-95% of cases. Occasionally the varicocoele can recur in the future.

After varicocoele repair, the size of the mass in your scrotum should reduce, but it usually won’t go away completely.

If the operation is performed for pain, varicocoele repair should improve or resolve your pain. However, there are many different causes for scrotal pain. If the varicocoele isn’t the cause of your pain, it may not improve after the operation.

If the operation is performed to improve fertility, it can take 3 – 12 months for your sperm quality to improve. 50-70% of men who have a varicocoele repair will have improvement in sperm quality on testing. However, infertility is often due to multiple factors, so improved sperm quality doesn’t always increase your chance of having a pregnancy.

If you have a small testicle due to a varicocoele, varicocoele repair can lead to ‘catch up’ growth of the testicle in teenagers, but usually doesn’t result in increased testicular size in adult men.