Varicocele Repair

What is this procedure?

A varicocele is an enlargement of the veins within the scrotum (similar to varicose veins in the leg) that drain the testicle. Varicoceles can cause scrotal discomfort, a dragging sensation, and in some men they are associated with impaired sperm production and male-factor infertility. Varicocele repair aims to tie off or seal the abnormally dilated veins while preserving the artery and lymphatics that supply the testicle. The most precise approach is microsurgical varicocelectomy, performed through a small incision in the groin under magnification; a laparoscopic (keyhole) approach is an alternative. The operation is usually carried out under general anaesthesia as a day case or with one overnight stay.

Before your procedure

• Fasting: Do not eat or drink for six hours before admission.
• Medications: Inform the team of all blood-thinning medications — these may need to be paused. Do not stop them without specific instructions.
• Shaving: Do not shave the groin or scrotal area yourself; this will be done aseptically if needed.
• What to bring: Supportive underwear or a scrotal support (athletic supporter), comfortable loose trousers, photo ID and insurance documents.

What happens during the procedure

For microsurgical repair, a small (2–3 cm) incision is made just above the groin crease. Under operating microscope magnification, the dilated veins are individually identified and ligated (tied off) while carefully preserving the testicular artery, lymphatic vessels, and vas deferens. For a laparoscopic approach, three small port incisions are used in the abdomen. Both methods take approximately 45–90 minutes. Absorbable stitches are normally used so there is nothing to remove.

After the procedure and recovery

• Scrotal support: Wear supportive underwear or a scrotal support continuously for two weeks to minimise swelling and discomfort.
• Swelling and bruising: Mild scrotal swelling, bruising, and discomfort are expected for one to two weeks. Paracetamol and ibuprofen are usually sufficient; ice packs (wrapped in a cloth) may also help.
• Driving: Do not drive for 24 hours after general anaesthesia. Avoid driving until you can perform an emergency stop comfortably.
• Return to work: Desk-based work is usually possible within one week. Manual or physical work should be avoided for two to three weeks.
• Activity: No sport or heavy lifting for three to four weeks.
• Sexual activity: Avoid for two to three weeks.
• Fertility: Improvement in sperm parameters, where applicable, typically becomes apparent on semen analysis at three to six months post-operatively.

When to seek medical help

Contact the secretary on 22 444 444 or El Greco Medical Centre +357 22 782 000 out of hours if you experience:

• Fever above 38 °C
• Rapidly expanding swelling or haematoma in the scrotum or groin
• Severe pain not responding to simple analgesia
• Signs of wound infection: increasing redness, warmth, discharge, or wound opening

Attend the nearest Accident & Emergency department if you feel acutely unwell or cannot reach us.