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Do you have a visible lump or swelling in the scrotum? These symptoms could indicate the presence of varicocele. At Pristyn Care, we provide comprehensive care and treatment for varicocele. We house highly experienced doctors who are trained in traditional and modern techniques of Varicocele Surgery. Get in touch with us and get a cost estimate for Varicocele Surgery.
Do you have a visible lump or swelling in the scrotum? These symptoms ... Read More
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A varicocele is an abnormal dilatation of the testicular veins due to defective venous valves, resulting in impaired blood drainage from the testicles. This leads to venous reflux, higher scrotal temperature, oxidative stress, and potential damage to sperm production and function.
• Disease name
Varicocele
• Surgery name
Varicocelectomy
• Duration
30-45 minutes
• Treated by
General Surgeon
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Varicocele primarily results from malfunctioning venous valves within the testicular veins, leading to blood pooling and vein dilation.
| Cause for Varicocele | Description |
| Valve Dysfunction | Weak or missing valves let blood flow backward. |
| Anatomical Factors | The left testicular vein is built in a way that causes higher blood pressure in it. |
| Increased Venous Pressure | Physical exertion, prolonged standing, or heavy lifting may cause congestion. |
| Genetic Predisposition | Some families show a pattern where several members are affected, likely because weak vein walls or valves run in the family and make them more prone to the condition. |
| Testicular or Venous Abnormalities | Abnormalities in the testicular veins or valves can impair blood flow, leading to the development of a varicocele. |
Varicoceles are usually classified into grades on the basis of how easily they can be felt or seen:
| Grade | Description |
| Grade 0 | It can’t be seen or felt by hand; it is only picked up through an ultrasound. |
| Grade I | Small and can only be felt when the person strains, like during a Valsalva maneuver. |
| Grade II | Moderate, palpable without Valsalva but not visible |
| Grade III | Large, visible, and palpable through the scrotal skin (often described as a “bag of worms”) |
Two sub-categories include primary and secondary varicocele:
Secondary Varicocele: This type is less commonly seen and usually results from increased pressure in the veins due to an underlying mass or obstruction.
Varicoceles often present with minimal or no noticeable symptoms. However, a thorough clinical examination can help identify certain characteristic signs.
Men with a varicocele often feel a dull ache or heaviness in the scrotum or testicle. It’s commonly described as a dragging sensation that tends to get worse as the day goes on, especially after standing for long hours, working out, or being in hot weather. Relief is typically noted when lying down. This is often the earliest symptom prompting individuals to seek the best varicocele treatment. Pain may be mild but can intensify in cases of inflammation or venous thrombosis. Some may experience throbbing discomfort during or after exertion.
Dilated veins are often described as feeling like a bag of worms within the scrotum. These are most evident when standing or performing a forceful exhalation. In more pronounced cases, a varicocele may appear as a noticeable lump or swelling above the testicle.
In some cases among adolescents, one testicle may look smaller or less developed. This happens when poor blood flow and increased heat affect the normal growth and function of the testicle.
Some individuals report a sense of fullness or mild swelling in the scrotum, typically on one side. While subtle, this may be mistaken for a hernia or hydrocele.
A substantial portion of men presenting for infertility evaluations are found to have varicoceles. These may cause oligospermia, also known as low sperm count, asthenospermia, commonly known as poor motility, and abnormal sperm morphology as documented on semen analysis.
In rare cases, long-standing varicoceles may contribute to hypogonadism. Symptoms can include low libido, fatigue, decreased muscle mass, and erectile dysfunction. A painless lump or subtle fullness may also be noticed.
Though uncommon, varicoceles can affect both sides, compounding discomfort and risk of infertility.
Many varicoceles are silent and only discovered incidentally, during routine exams or fertility assessments. Subclinical varicoceles are not detectable on physical examination but appear on scrotal ultrasound. Even in the absence of symptoms, treatment may be recommended if semen parameters are abnormal or if testicular growth is impaired.
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During a clinical exam, the doctor usually checks for varicoceles while the patient is standing and lying down. To make the veins more noticeable, the patient may be asked to perform the Valsalva maneuver, forcefully exhaling while holding the breath. If the varicocele is present, the veins may feel enlarged or twisted to the touch. In more severe cases, these veins can also be seen on visual inspection.
Considered the gold standard for confirming varicocele. This non-invasive imaging modality assesses vein diameter, detects reverse blood flow (reflux) during Valsalva, and can identify subclinical or bilateral varicoceles not evident on physical examination. Ultrasound also helps exclude other scrotal pathologies.
Performed in men concerned with fertility. Identifies abnormal semen volume, count, motility, and morphology that may correlate with testicular dysfunction from varicocele. Serial analyses are recommended to monitor changes post-treatment.
Doctors may recommend blood tests to check hormones like testosterone, FSH, and LH. These help assess whether the varicocele is affecting overall hormone balance.
A thorough clinical evaluation, supported by focused imaging, helps confirm the diagnosis with accuracy. This evaluation also helps determine the right course of treatment and ensures that other serious or potentially harmful conditions with similar symptoms aren’t overlooked.
Intervention is warranted for:
Cosmetic/psychological distress: May be considered in select cases where varicocele causes significant body image distress, though this is not a primary clinical indication and lacks robust evidence for surgical benefit.
Management of varicocele comprises a spectrum from conservative medical therapy to advanced surgical and endovascular interventions. Selection of a treatment modality hinges on patient symptoms, fertility aspirations, anatomical considerations, and physician expertise. The following provides an in-depth, evidence-based overview of all principal approaches, their mechanisms, nuances, and clinical outcomes.
Conservative or non-surgical therapy is primarily reserved for patients with incidental, asymptomatic varicocele or in cases where patients decline or are not optimal candidates for operative intervention. It is important to understand that while these strategies may relieve discomfort, they do not correct the underlying venous reflux or improve semen parameters.
| Common Method | Description |
| Scrotal Support | Using snug, supportive undergarments or athletic supporters redistributes scrotal weight, minimizing venous stasis and alleviating mild dragging pain or heaviness. |
| Pharmacological Management | Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can transiently relieve scrotal pain but are not indicated for long-term use in the absence of persistent inflammation. |
| Lifestyle Modifications | Strategies include minimizing prolonged standing, avoiding strenuous physical activity or heavy lifting, and maintaining a healthy weight. Regular breaks and elevation of the scrotum during rest may offer symptomatic respite. |
| Other Methods | Cold packs may reduce acute swelling, though they are not suitable as a chronic therapy. Monitoring testicular size, semen quality in men of reproductive age, and symptoms at regular intervals. |
Surgical repair, also known as varicocelectomy, is the gold standard for patients with clinically significant varicocele, particularly for individuals with documented infertility, testicular atrophy, pronounced pain, or failed conservative management. Surgical objectives are to interrupt pathologic venous reflux while preserving healthy testicular arteries and lymphatic vessels, thereby ensuring optimal testicular function and minimizing complications.
| Surgical Treatment Method | Technique | Outcomes |
| Microsurgical Varicocelectomy | Conducted via a small incision at the groin or below the inguinal ligament. An operating microscope is used to accurately identify and ligate aberrant spermatic veins while preserving the testicular artery and lymphatics. |
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| Laparoscopic Varicocelectomy | Performed typically under general anesthesia using 2–3 small abdominal ports; the internal spermatic veins are isolated and divided under video-laparoscopic visualization. |
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| Percutaneous Embolization | Under local anesthesia and interventional radiology guidance, a thin catheter is introduced via the femoral or jugular vein. Embolic agents are precisely deployed to obstruct the refluxing internal spermatic vein, eliminating the backward blood flow. |
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Knowing which method is the most suitable for an individual’s varicocele treatment is crucial. Below mentioned are some points to consider:
All treatment options should be discussed following a comprehensive patient health assessment, fertility desires, and anatomical findings. Multidisciplinary evaluation often yields the best outcomes and patient satisfaction.
The cost for varicocele treatment in India depends on several factors. Yet many individuals, both Indian and International patients, choose to get treated here because the care is reliable and the costs are generally lower compared to many other countries.
| Type of Treatment | Cost Range |
| Microsurgical Varicocelectomy | ₹40,000 – ₹70,000 |
| Laparoscopic Varicocelectomy | ₹35,000 – ₹65,000 |
| Open Varicocelectomy | ₹30,000 – ₹40,000 |
| Percutaneous Embolization | ₹65,000 – ₹75,000 |
Though varicocele treatment is usually safe and successful, there are some risks involved. The extent of risks depends on the type of procedure performed. Being aware of possible complications helps doctors choose the right approach, ensures patients are well-informed, and allows for better care after surgery.
Although uncommon with modern techniques, risks include airway complications, cardiovascular events, allergic responses, and postoperative nausea/vomiting. Pre-anesthesia evaluation mitigates these.
The comprehensive understanding of varicocele shows the importance of timely and precise intervention. Surgical and endovascular treatments can effectively improve testicular function and relieve symptoms. These options have proven results and are chosen based on each patient’s specific needs.
To get the best long-term outcome, it’s important to have a full-evaluation by different specialists, an experienced surgical team, and a treatment at a well-equipped hospital. After surgery, proper care and follow-up help speed up recovery and improve fertility.
Talk to a urologist or interventional radiologist to find the best treatment based on your test results and reproductive goals. A clear, coordinated plan ensures accurate diagnosis, effective treatment, and regular monitoring.
Varicocele treatment is recommended for infertility, testicular pain, atrophy, or hormonal issues. Small, symptom-free varicoceles can be monitored unless symptoms worsen. Conservative care may ease discomfort but doesn’t improve fertility or reverse testicular damage.
Varicoceles are mainly caused by faulty valves in the testicular veins, leading to blood backflow and vein swelling. The left testicular vein drains at a right angle into the left renal vein, causing higher pressure and making the left side more prone to varicoceles. This is seen in over 80% of the cases. Genetics and factors like heavy lifting can worsen the condition.
Treatment often improves semen quality and boosts pregnancy rates in 30–50% of couples. Results usually appear 3–6 months after treatment, depending on varicocele severity and female partner’s fertility factors.
Clinical examination with the patient standing and Valsalva maneuver remains the initial step, grading palpable varicoceles I to III. Scrotal Doppler ultrasound is the gold standard for confirming diagnosis, detecting reflux, measuring vein diameter, and identifying subclinical or bilateral cases. Semen analysis and hormonal profiling help evaluate fertility impact and guide treatment decisions.
Though minimally invasive, embolization carries risks including coil migration, causing vascular obstruction, allergic reactions to contrast agents, technical failures due to challenging vascular anatomy, and recurrence from collateral vein development. Minor puncture site bruising and postembolization syndrome (low-grade fever, mild pain) may occur but usually resolve swiftly. Expertise in interventional radiology mitigates most adverse events.
It is a medical condition where the gonads, ie, testes in males, decrease the level of testosterone production. Recent studies suggest that varicoceles and hypogonadism are associated. Effective repair of one’s varicocele can easily help increase the testosterone levels in a male patient.
In patients with symptomatic varicocele, practical lifestyle adjustments can help reduce venous congestion and alleviate scrotal discomfort. These include avoiding prolonged standing, refraining from heavy lifting, and maintaining a healthy weight. Scrotal support garments can alleviate heaviness or aching. However, these measures do not reverse varicocele pathology or improve fertility and should complement but not replace definitive treatment when indicated.
Embolization is preferable for patients seeking outpatient minimally invasive treatment, those with bilateral varicoceles, which can be treated in one session, individuals with prior failed surgical repairs (recurrent varicocele), and patients considered high risk for anesthesia or surgery. Its shorter recovery time and reduced scarring also appeal to certain patient populations.
Decision-making should be guided by a thorough evaluation of varicocele severity, symptomatology, fertility objectives, and individual treatment preferences. Key considerations include the expertise of the surgical or interventional team, hospital accreditation (such as JCI or NABH), access to microsurgical techniques, and clarity regarding costs and expected outcomes.
Kowthem
Recommends
The surgery went smoothly, and Dr. Daiyapan Ghosh provided a clear explanation of the procedure, making the experience reassuring. I highly recommend his expertise. Had varicocele surgery at pristyncare sheetla. Doctors were professional and didn't make it uncomfortable. Pain reduced and no major complications. Additionally, the complimentary food and cab services were a thoughtful touch.
Mukesh
Recommends
Went in for a varicocele surgery. I was nervous at first, but the doctor was reassuring and explained the procedure well. I’m happy with the results.
Madhu
Recommends
I went to visit with not 100% confidence but once I discussed was 100% sure and paid advance and fixed the procedure ! He was very comfortable to talk with.
Lokeshkumar
Recommends
Good approach
Kunal Azad
Recommends
Pristyn Care's varicocele treatment was a life-changer for me. Dealing with the discomfort and swelling in my scrotum was concerning, but their urology team was incredibly supportive and understanding. They recommended a personalized treatment plan to address my varicocele effectively. The procedure was performed with great care, and Pristyn Care's post-operative care was exceptional. Thanks to them, my varicocele symptoms have improved significantly, and I highly recommend Pristyn Care for their expert care
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