Q: How to treat a varicocele?

Varicoceles can be treated if they are causing symptoms such as pain in the scrotum or they affect a man’s fertility by affecting the sperm quality of a man. In these cases, varicoceles can be treated by three general methods. The first method is that the varicocele can be ligated or tied off with a laparoscopic surgery. During this surgery which is performed under a general light anesthesia, three holes of 5mm each is made onto the abdomen of the man. Through the holes, the abnormally large veins are located and they are then dissected, clipped and divided. With this, disruption of blood flow to the varicocele occurs and the varicoceles eventually will block off and shrivel off. Another method of treating varicocele is by performing a microsurgery surgery. This is again, performed under general anesthesia where two cuts are made in the groin of the affected man, one on the right and one on the left. Each cut measure about 2cm and from there, the varicoceles are located, tied off, and divided. A final and less common way of treating varicocele is by embolisation. In this procedure, the person does not need general anesthesia. He only requires sedation and local anesthetic infiltration to the tied region. Under x-ray guidance, the veins in the tied leg is cannulated or punctured and then a guide wire is passed through the vein to locate the abnormal varicoceles. Once located, these abnormal varicoceles are blocked off by internal plugs that are deployed via the vein puncture. The entire procedure may take 30 to 40 minutes by no surgery involved in this procedure.

Answered by: Dr Ho Siew Hong

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