Microscopic Varicocelectomy
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Testis is the male reproductive organ where the sperms are produced. The process of sperm production is called spermatogenesis.
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Varicocele is the enlargement/ dilation of the veins which carry blood from the testis to the heart.
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15% of all males have a varicocele and it can cause infertility (very common)
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Good thing is that it is a correctable cause of infertility in majority of the cases.
The veins carrying blood back to the heart have defective valves leading to pooling of blood in them which in turn affects inflow of blood and causes ischemia.
The surgery should be done under 15-20X magnification to visualize the structures adequately
The dilated veins have to be tied at one level and at the same time the gonadal artery (red), vasal artery and vein (blue) and the lymphatics (black) have to be preserved to avoid testicular atrophy, recurrence and hydrocele formation.
Success of Varicocelectomy
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In properly selected cases – very high (50 – 70%) success rates
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Higher chances if varicocele perse is the main cause of the infertility
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Clinical judgement is of utmost importance
Microsurgical subinguinal varicocelectomy
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Advantages & USP : (It is the current procedure of choice)
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Artery is preserved under microscope
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Bad Veins are ligated, preserves good veins
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Very high success rate compared to other techniques
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Very small incison
Requirements to perform this procedure
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Surgeon acquainted to microsurgery
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Microscope
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Expertise – surgeon peforming the procedure repeatedly