Microsurgical Varicocelectomy

Varicocele is the enlargement of the veins in the scrotum and is one of the most common causes of male infertility. This condition increases the temperature around the testicles, which can negatively affect sperm production and quality. Microsurgical varicocelectomy is the most effective and reliable method for the permanent treatment of varicocele.

What is Varicocele?

Varicocele occurs when the veins surrounding the testicle (pampiniform plexus) become enlarged, similar to varicose veins in the legs.
These enlarged veins prevent proper blood drainage from the testicle, leading to increased testicular temperature.

Over time, this can reduce sperm production and motility, and in some cases, lead to testicular shrinkage (atrophy).

Symptoms

Varicocele may be asymptomatic, but common signs include:

• Pain or a feeling of heaviness in the testicle or groin

• Discomfort that increases with standing or exercise

• Asymmetry or shrinkage of the testicles

• Infertility (difficulty conceiving)

• Abnormal sperm count or motility on semen analysis

Diagnosis

Varicocele is usually diagnosed through physical examination.
The physician examines the scrotum while the patient is standing to feel the enlarged veins.
In some cases, color Doppler ultrasound is used to confirm the diagnosis.

Treatment: Microsurgical Varicocelectomy

Microsurgical varicocelectomy is considered the gold standard for varicocele treatment.
During this procedure, enlarged veins are carefully ligated under a microscope, while the arteries and lymphatic vessels supplying the testicle are preserved.
This approach minimizes the risk of recurrence (varicocele returning) and hydrocele (fluid accumulation).

How is the Surgery Performed?

• Typically performed under local or general anesthesia

• A small 2–3 cm incision is made in the groin area

• Surgery is conducted under a microscope with 8–10x magnification

• Enlarged veins are carefully tied off while normal testicular blood flow is maintained

• Operation duration is approximately 45–60 minutes

Postoperative Course

• Patients are usually discharged the same day

• Return to daily activities is rapid

• Pain usually resolves within 1–2 weeks

• Improvement in sperm production begins within 3–6 months

• Sperm quality improves and pregnancy rates significantly increase

Advantages

• Highest success rate among varicocele treatments

• Low risk of complications and recurrence

• Small, cosmetic incision

• Rapid recovery

• Preservation of testicular function

Who is a Candidate?

Microsurgical varicocelectomy is recommended for men with:

• Infertility and abnormal sperm parameters

• Testicular pain affecting quality of life

• Testicular atrophy or reduced testicular volume

• Varicocele detected at a young age

Conclusion

Microsurgical varicocelectomy is currently the safest and most effective method for permanent varicocele treatment.
Performed by experienced surgeons, it achieves high success rates, with significant improvement in sperm parameters for most patients.

In our clinic, microsurgical varicocelectomy is performed with modern equipment, prioritizing patient safety and comfort, aiming to ensure both pain-free living and enhanced natural fertility.