Varicocele treatment may not be necessary. Many men with varicoceles are able to father a child without treatment. However, if the varicocele causes pain, testicular atrophy, or infertility, or if you are considering assisted reproductive technologies, you may need surgery to treat the varicocele.

The goal of surgery is to close the affected vein to redirect blood flow to normal veins. In cases of male infertility, varicocele treatment may improve or cure infertility or improve sperm quality if techniques such as in vitro fertilization are used.

Clear indications for varicocele treatment in adolescence include progressive testicular atrophy, pain, or abnormal semen analysis results. Although varicocele treatment generally improves sperm characteristics, it is not clear whether varicoceles lead to poor sperm quality over time.

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1. Open Surgery:

2. Laparoscopic Surgery: The surgeon makes a small incision in the abdomen and passes a fine instrument through the incision to view and treat the varicocele. This procedure requires general anesthesia.

3. Percutaneous Embolization: A radiologist inserts a tube into a vein in the groin or neck, through which instruments can be passed. Visualizing the dilated veins on a monitor, the doctor releases a solution or scarring coils to create blockages in the testicular arteries, restricting blood flow and treating the varicocele. This procedure is not as widely used as surgery.

After embolization, you can return to work after two days and resume exercise after seven to 10 days.

This surgery is usually performed as an outpatient procedure, using general or local anesthesia. Typically, the surgeon will access the vein through the groin (inguinal or subinguinal), but it is also possible to make an incision in the abdomen or below the groin.

Advances in varicocele treatment have reduced post-operative complications. One result of this is the use of a surgical microscope, which allows the surgeon to better view the treatment area during surgery. Another is the use of Doppler ultrasound, which helps guide the procedure.

You may be able to return to normal, non-strenuous activities after two days. As long as you are not uncomfortable, you may return to more strenuous activities, such as exercise, after two weeks.

The pain from this surgery is generally mild but may persist for several days or weeks. Your doctor may prescribe pain medication for a limited period after surgery. Afterward, your doctor may recommend over-the-counter pain relievers, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others) for pain relief.

Your doctor may advise you to abstain from sexual intercourse for a period of time. In most cases, it will take several months after surgery before improvements in sperm quality can be seen through a semen analysis. This is because it takes about three months for new sperm to be produced.

Open surgery using a microscope and accessing the subinguinal area has the highest success rates compared to other surgical methods.