A varicoele is a collection of veins in the scrotum that can cause pain, swelling and reduced growth of the testis. The problem is almost always on the left because of the connection of the left testicular vein to the renal vein, the subsequent longer course than on the right and the resultant failue of the valves to hold the head of pressure.
Failure of the growth of the testicle is the main reason for intervention. The surgery can involve an open operation, laparoscopic division of the vessels or blocking of the veins radiologically.
My preferred technique is ligation of both the testicular vein and artery, relying of the blood supply from the Vas. The risks are of infection, bleeding, hydrocele (fluid collection in the scrotum) and damage to the testicle.
The success of the procedure is high, but the veins are not usually totally oblitered and more than one operation may be necessary.
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