This page contains a Flash digital edition of a book.
after a varicocele repair. A varicocele repair also has been shown to improve serum follicle- stimulating hormone and serum testosterone levels in some patients.


FREQUENTLY ASKED QUESTIONS:


What will happen if I choose to observe my varicocele, rather than undergo treatment? Failure to treat a varicocele may result in testicular atrophy and/or a decline in semen quality. This may lead to infertility. In most cases, if a varicocele is not treated, no major general health issues will develop.


I have pain with my varicocele. What can I do to help alleviate the pain? Pain associated with a varicocele is uncommon. The use of adequate scrotal support (e.g., athletic supporter, briefs style underwear, etc.) can help the pain associated with a varicocele. Lying on your back facilitates varicocele drainage and often improves episodic discomfort as well. Use of analgesic agents (e.g., acetaminophen, ibuprofen, etc.) may be of benefit in treating the pain associated with a varicocele. Additionally, many patients obtain lasting relief of symptoms with varicocele correction through the above-mentioned techniques. Patients with pain that is not typical of “varicocele pain” (as described earlier) are less likely to be helped with surgical repair.


I am considering having my varicocele corrected for fertility reasons. How long will I have to wait to see improvement in semen parameters? Semen analyses are typically obtained at three to four month intervals after the procedure. Improvement is often seen within six months, but may not be observed until one year postoperatively.


My adolescent son was recently diagnosed with a varicocele. Should this be corrected? Indications for correction of a varicocele in an adolescent include difference in testicular size, with the affected side being smaller than the unaffected side. Additionally, correction is a consideration in patients with pain. Treatment of adolescents is highly individualized, and


consultation with a urologist to further discuss the appropriateness of treatment for a particular patient is highly recommended. Often patients or families will choose to repair varicoceles to minimize the potential risk for future fertility or minimize the concerns about this complication.


I am not interested in fertility and have no symptoms. Should I have my varicocele repaired? Generally, asymptomatic varicoceles are not repaired. Most physicians do not believe there are health consequences of untreated asymptomatic varicoceles unless fertility issues are present.


Have there been any advances in the surgical treatment of varicoceles? Two major advances in the surgical repair of the varicocele have been the surgical microscope and use of the intraoperative Doppler ultrasound. The main advantage of microsurgical (microscopic) repair over nonmicrosurgical (nonmicroscopic) repair is the significant reduction in postoperative complications, such as testicular artery injury, hydrocele formation, and varicocele recurrence. The complication rates for hydrocele formation with nonmicrosurgical technique range from 3% to 39%, whereas hydrocele formation is rarely reported with a microsurgical technique. These improved results are thought to be caused by the greater ability to identify and preserve individual lymphatics. The recurrence rate for microscopic varicocelectomy has been reported between 1% and 2% compared with 9% and 16% for nonmicroscopic inguinal varicocele repair.


The micro Doppler is another advance that has improved the outcomes in varicocele repair. Studies have found that microsurgical varicocelectomy combined with intraoperative Doppler ultrasound improved preservation of the testicular artery and increased the number of veins ligated.


Resources for further information:


http://www.asrm.org/uploadedFiles/ASRM_Content/News_and_Publications/ Practice_Guidelines/Joint_Reports/Report on_varicocele(1).pdf www.varicocelespecialists.com www.ssmr.org http://www.fertilitylifelines.com/intheknow/index.jsp#top


THE RESOURCES LISTED IN THIS DIRECTORY ARE UNSCREENED AND SHOULD NOT BE VIEWED AS RECOMMENDATIONS OR ENDORSEMENTS, EITHER EXPRESS OR IMPLIED, BY THE AFA. 61


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76  |  Page 77  |  Page 78  |  Page 79  |  Page 80  |  Page 81  |  Page 82  |  Page 83  |  Page 84  |  Page 85  |  Page 86  |  Page 87  |  Page 88  |  Page 89  |  Page 90  |  Page 91  |  Page 92  |  Page 93  |  Page 94  |  Page 95  |  Page 96  |  Page 97  |  Page 98  |  Page 99  |  Page 100  |  Page 101  |  Page 102  |  Page 103  |  Page 104  |  Page 105  |  Page 106  |  Page 107  |  Page 108  |  Page 109  |  Page 110  |  Page 111  |  Page 112  |  Page 113  |  Page 114  |  Page 115  |  Page 116  |  Page 117  |  Page 118  |  Page 119  |  Page 120  |  Page 121  |  Page 122  |  Page 123  |  Page 124  |  Page 125  |  Page 126  |  Page 127  |  Page 128  |  Page 129  |  Page 130  |  Page 131  |  Page 132  |  Page 133  |  Page 134  |  Page 135  |  Page 136  |  Page 137  |  Page 138  |  Page 139  |  Page 140  |  Page 141  |  Page 142  |  Page 143  |  Page 144  |  Page 145  |  Page 146  |  Page 147  |  Page 148  |  Page 149  |  Page 150  |  Page 151  |  Page 152  |  Page 153  |  Page 154  |  Page 155  |  Page 156  |  Page 157  |  Page 158  |  Page 159  |  Page 160  |  Page 161  |  Page 162  |  Page 163  |  Page 164  |  Page 165  |  Page 166  |  Page 167  |  Page 168