Recently the scrotal ultrasound has been found to be an accurate way of confirming the presence of a varicocele. The size of the veins and abnormal blood flow can be seen and measured using the ultrasound. Repair of the varicocele is indicated when the couple has documented infertility with normal or potentially normal female partner but a male with one or more abnormal semen parameters and the presence of a varicocele on physical exam. Repair should be done when a varicocele causes testicular pain or discomfort or there is a significant discrepancy between the size of the two testicles. Treatment options to aid with fertility include surgical varicocele repair, angiographic embolization, intrauterine insemination, in-vitro fertilization and medical therapy with clomid.
Surgical repair offers the best results.
Twenty percent of these men were able to father children after varicocele repair without any other assistance. Surgery is performed through a one and one half inch incision made below the belt line with a technique called microsurgical inguinal varicocele repair. The testicular artery and small lymphatic channels are identified using the microscope and are preserved. This limits potential complications. Surgery is performed on an outpatient basis and generally takes 30-45 minutes to complete.