A varicocele is an abnormal enlargement, twisting and elongation of testicle and scrotum venous vessels that form the pampiniform venous plexus in the scrotum. The pampiniform venous plexus as a part of spermatic cord courses through the inguinal canal to the abdominal cavity. Testicular vessels merge larger and less numerous venous trunks and eventually they form testicular veins that join the inferior vena cava on the right and renal vein on the left.
Varicocele formation is mainly related to the above mentioned anatomy. Left testicular vein is significantly longer than the right one and it connects the left renal vein at a right angle, what causes a turbulent blood flow and impairs the blood outflow from the left testicle. If a man additionally has venous valves insufficiency or suffers from their congenital absence, the prevention of backflow fails, what leads to gradual widening of the pampiniform plexus vessels and varicocele formation on the left side. The abnormal venous blood flow from abdominal cavity to the testis appears often during physical activities as the abdominal muscles tighten. It leads to hypoxia of testicular cells and increase in their temperature, which may result in pain in scrotal and inguinal region, impaired sperm formation and fertility disorders as consequence.
Laparoscopic varicocelectomy is currently one of the most effective methods of varicocele treatment. The procedure is performed under general anesthesia. At the beginning of the surgery, a urologist makes 3 small skin incisions, usually one above the umbilicus and two in the hypogastrium, and places trocars that allows to insert a camera and surgical instruments. During the procedure, the testicular vein is dissected and closed with special clips. At the end, the instruments are removed and the skin in sutured.
Postoperative recommendations:
- Urological control 7 days after the surgery in order to remove the skin sutures;
- If the indication for the surgery was reduced sperm quality, it is necessary to perform control analysis 3 months after the procedure.
