Patient's question:
I have varicocele for a while now, and the symptoms have been getting worse recently. I also feel pain in the groin area, and the testicles feel like there are worms coiled on them when touched. I've heard this condition can affect fertility. I've been married for over a year and I'm really worried. Could you please advise on the best treatment for varicocele?Doctor's answer:
For varicocele, not all cases require surgical treatment. For younger individuals who have not yet married and exhibit symptoms, a scrotal support can be used to lower the scrotum, which can alleviate the symptoms. These patients often find that their symptoms disappear after marriage. For more severe symptoms, high ligation of the internal spermatic vein can be performed. This involves ligating all branches of the internal spermatic vein at the internal inguinal ring. If any branches are missed, it can lead to recurrence. After internal spermatic vein ligation, venous blood from the testis, epididymis, and other areas can return to the inferior vena cava via the external spermatic vein. Alternatively, it can return to the femoral vein through subcutaneous veins below the external inguinal ring. Ligation of the internal spermatic vein above the internal inguinal ring is typically reserved for cases of recurrence. This surgical approach is considered when there is a high likelihood of adhesions from previous incisions.