Microsurgical varicocelectomy Surgical treatment of varicoceles with a surgical microscope

Varicocelectomy is a surgical procedure used to treat varicocele (abnormal enlargements of the veins within the scrotum) and is performed to treat associated male infertility or alleviate discomfort and pain.

The Microsurgical technique involves the use of a surgical microscope for greater precision in the procedure.

This treatment is clinically indicated in cases of male infertility (varicocele may affect sperm quality, reducing sperm count, motility and morphology), in cases where varicocele causes significant pain or discomfort, or in cases of testicular atrophy, where varicocele leads to a reduction in testicular size.

The surgical procedure is usually performed under general anesthesia or sedation, involving a small incision in the inguinal region. The dilated veins are identified and ligated to stop abnormal blood flow, while the arteries, lymphatic vessels, and vas deferens are carefully preserved to avoid damage to the reproductive system.

Using the Microsurgical technique provides the following advantages:
 - Allows for detailed visualization, reducing the risk of injury to adjacent structures;
 - Lower risk of complications, particularly hydrocele (fluid accumulation around the testicle) and arterial injury;
 - Lower recurrence rate of varicocele compared to other techniques;
 - Generally, patients experience less postoperative pain and have a quicker recovery.

Rest is recommended for the first 24 to 48 hours after surgery, along with the use of analgesics for pain management. Intense physical activities and heavy lifting should be avoided for 4 weeks. Follow-up with a urologist is necessary to assess recovery and the effectiveness of the procedure.

Microsurgical varicocelectomy is an effective procedure for treatment of varicocele, especially in men with infertility or associated pain. The use of the microsurgical technique offers several advantages in terms of precision, reduced complications, and recovery. The decision to undergo this procedure should be discussed with a specialized urologist, considering the specific conditions of each patient and the expected benefits.