Prognosis
Varicocele is usually harmless except in cases of infertility. If surgery is required because of infertility or testicular atrophy, the outlook is usually excellent. Removal of varicocele can lead to normal testicular temperatures and an increased sperm production.[10] Despite this, recent research (as discussed below) has resulted in doubts if treatment of the condition using this method actually improves fertility.
[edit] Varicocele and Infertility
Recent researches show that varicocele is the main cause for male infertilty. In fact Varicocele is the reason for about 80-90% of male infertility cases. That was found by Dr Yigal Gat and Dr Menahem Goren in one of their massive studies on varicocele which was published in the renowned medical journal - Human Reproduction.[11]
Varicoceles may be managed with a scrotal support (e.g. jockstrap, briefs). However, if pain continues or if infertility or testicular atrophy results, the varicocele may need to be surgically ligated (tied off). A vasotonic drug is preferred in addition to the scrotal support.
Sew up wound after varicocele surgeryVaricocelectomy, the surgical correction of a varicocele, is performed on an outpatient basis.[6] The three most common approaches are inguinal (groin), retroperitoneal (abdominal), and infrainguinal/subinguinal (below the groin). Various other techniques may be used. Ice packs should be kept to the area for the first 24 hours after surgery to reduce swelling. The patient may be advised to wear a scrotal support for some time after surgery.
Possible complications of this procedure include hematoma (bleeding into tissues), infection, or injury to the scrotal tissue or structures. In addition, injury to the artery that supplies the testicle may occur.
An alternative to surgery is embolization,[7] a minimally invasive treatment for varicocele that is performed by an interventional radiologist. This involves passing a small wire through a peripheral vein and into the abdominal veins that drain the testes. Through a small flexible catheter, this doctor can obstruct the veins so that the increased pressures from the abdomen are no longer transmitted to the testicles. The testicles then drain through smaller collateral veins. The recovery period is significantly less than with surgery and the risk of complications is minimised. However, overall effectiveness is not as high as surgery, which is still an option.
Embolization is an effective treatment for post-surgical varicoceles. These are varicoceles that reappear after they have been surgically repaired. The main theory is the presence of redundant gonadal veins that provide collateralization cause the reappearance of the varicoceles. The use of NBCA glues during the embolization is as effective at embolizing these collaterals as coils. [8]
Two Israeli doctors, Yigal Gat and Menahem Goren have developed the Gat-Goren nonsurgical method for treating varicoceles. During the procedure, performed under local anesthesia, a catheter is inserted through a vein in the upper thigh. Fluid injected through the catheter selectively closes off the malfunctioning veins, thus enabling the testicular tissues to recover and begin to produce normal sperm in normal amounts. The procedure lasts one to two hours and causes almost no discomfort. The patient can return to his regular routine within 48 hours.
WIKIPEDIA ARTICLE..........not always accurate but good info nonetheless