Varicocele (abnormally dilated veins in the testes) repair can be performed surgically or non-surgically. Neither method is considered preferable to the other, and should be decided based on individual patient circumstances.
The non-surgical repair is a minimally invasive technique performed by an interventional radiologist on an outpatient basis. The success rate varies significantly dependent upon the experience of the radiologist, the anatomy of the patient and the presence of varicoceles on both sides.
Microsurgical varicocelectomy is an outpatient procedure performed under general anesthesia through a small incision in the lower groin. This procedure has the greatest chance of repair with the least morbidity and lowest cost. Non-surgical approach is utilized primarily in patients with a previously failed surgical repair, pain as the main indication and body features that increase the risk of surgery, such as morbid obesity.
Potential complications from varicocele repair include persistent/recurrent varicocele, bruising, infection and testicular tenderness. A hydrocele, collection of water around the testes, occurs in an extremely small number of men. For those patients undergoing the non-surgical repair, there is the added risk of reaction to the contrast agent used in the procedure. There is an extremely low risk of loss of the testicle.