A varicocele is an enlargement of the veins in the scrotum, the bag that contains the testes. They are similar to varicose veins of the leg and affect a type of vein known as the pampiniform plexus.
The pampiniform plexus is found in the spermatic cord. This cord also holds the vas deferens, the tube that carries sperm, and the testicular artery, which transports blood to the testicles.
Varicoceles are found in approximately 10% of men and are invariably found on the left side.
Treatment is often not required and is usually only considered in men with pain and discomfort that it not improved with pain killers or occasionally in men with infertility that is otherwise unexplained.
Treatment options include surgery or embolization.
There are many ways to perform varicocele surgery and all involve blocking the blood flow in the pampiniform plexus.
I perform the procedure on a day case basis under a general anaesthetic. I make an incision in the groin and through that incision I ligate (tie off) all the veins and preserve the vas deferens and testicular artery. The procedure takes approximately 40 minutes.