A microscopic sub-inguinal varicocelectomy offers the best chance of correcting a varicocele with minimal complications. This procedure is done in the outpatient setting under general anesthesia through a small incision in the groin (below the pubic hair line). We typically make a 1-2 cm incision in the groin and then bring the spermatic cord up to the skin. Once the spermatic cord is brought up to the skin, we bring in the operating microscope and perform the varicocelectomy at 30-40X magnification.

We open the external spermatic fascia (outside layer) under the microscope and then dissect out and divide each engorged spermatic cord vein. We also use a microscopic Doppler probe to identify and preserve the artery. For a description of this see Figure 1. This procedure typically takes 45 minutes and patients go home from the OR the same day. Most men have minimal pain after this procedure and often forget to take the pain pills that we provide. Men will have semen analysis at two-month intervals after this procedure to assess improvement in their sperm quality as a result of the procedure.

Figure 1: Varicocelectomy

A. Swollen vein in the spermatic cordvariocelectomy

B. Ligated venous branches of the spermatic cordvariococelectomy procedure

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