Recurrence of Varicocele After Surgery: Causes and Consequences - Urology

Share to:

Postoperative recurrence of varicocele?


Hello, doctor.
I underwent traditional hernia surgery on the left inguinal region when I was 18 years old.
At that time, I informed the physician about my issue with varicocele, and it was addressed during the same incision.
However, I soon discovered that the varicocele issue still persists.
Does this mean that the physician did not completely ligate the vein at that time? In this situation, what potential complications could arise for me? (For example, could it affect the normal veins?)

Chen Dada, 20~29 year old female. Ask Date: 2019/09/23

Dr. Du Shixi reply Urology


Hello: Varicocele is prone to recurrence, especially in individuals who exert themselves in the abdominal area or who stand or sit for prolonged periods.
Even if the veins are ligated, the body may demand blood flow, which could cause some smaller vessels to enlarge again without significant sequelae.
However, it is advisable to have a urology evaluation at the hospital to assess the severity of your varicocele, which may be beneficial.
Wishing you good health.

Reply Date: 2019/09/23

More Info


Recurrence of varicocele after surgery is a concern that many patients face, particularly those who have undergone surgical procedures like hernia repair where varicocele was also addressed. Varicocele, which is an enlargement of the veins within the scrotum, can lead to various complications, including infertility and discomfort. Understanding the causes of recurrence and its potential consequences is crucial for managing your health effectively.

Firstly, it is important to recognize that surgical treatment for varicocele, whether through traditional open surgery or laparoscopic techniques, aims to occlude the affected veins to prevent blood from pooling. However, recurrence can occur for several reasons:
1. Incomplete Ligation: If the surgeon did not completely ligate the affected veins, blood flow may continue, leading to a return of the varicocele. This could happen if the anatomy is complex or if there are multiple veins involved that were not adequately addressed during the procedure.

2. Collateral Circulation: The body has a remarkable ability to develop collateral circulation. If the primary vein is ligated, other veins may compensate and become engorged, leading to a recurrence of varicocele symptoms.

3. Surgical Technique: The technique used during the surgery can also influence the likelihood of recurrence. Some methods may have higher rates of recurrence than others, depending on how well they address the underlying venous issues.

4. Patient Factors: Individual anatomical variations, such as the presence of additional venous pathways or congenital abnormalities, can predispose a patient to recurrence. Hormonal factors and increased intra-abdominal pressure (from activities like heavy lifting) can also contribute.

Regarding the potential consequences of recurrence, there are several considerations:
- Infertility: One of the most significant concerns associated with varicocele is its impact on fertility. The heat and pressure from the enlarged veins can affect sperm production and quality. If the varicocele recurs, it may exacerbate any existing fertility issues.

- Pain and Discomfort: Recurrence can lead to the return of symptoms such as scrotal pain or a feeling of heaviness, which can affect daily activities and quality of life.

- Testicular Health: Chronic varicocele may impact testicular function and size over time. If left untreated, it could potentially lead to testicular atrophy.

If you suspect that your varicocele has recurred, it is essential to consult with your healthcare provider. They may recommend a physical examination and possibly imaging studies, such as a Doppler ultrasound, to assess the blood flow in the affected area. Depending on the findings, further intervention may be necessary, which could include a repeat surgical procedure or alternative treatments.

In terms of long-term management, it is advisable to monitor any symptoms and maintain open communication with your healthcare provider. If you experience significant discomfort or have concerns about fertility, discussing these issues with a urologist or a specialist in male reproductive health may provide additional insights and treatment options.

In conclusion, while recurrence of varicocele after surgery can be frustrating, understanding the underlying causes and potential consequences can help you take proactive steps in managing your health. Regular follow-ups and being vigilant about any changes in symptoms are key to ensuring the best possible outcomes.

Similar Q&A

Managing Recurrence of Varicocele: Prevention and Concerns After Surgery

Dear Doctor: 1. I have undergone two surgeries for varicocele, one on each side. Since the surgeries, I feel that the blood vessels in my testicles have not decreased but rather increased, and I am starting to notice signs of recurrence. Are there any preventive measures I can ...


Dr. Cai Bingkun reply Urology
Hello! Please take your questions to the surgeon who will perform your operation to see if there are any other issues. Currently, most surgeries for varicocele are performed using high ligation, which has good results and results in a relatively small incision!

[Read More] Managing Recurrence of Varicocele: Prevention and Concerns After Surgery


Understanding Recurrence After Varicocele Surgery: Symptoms and Concerns

Hello Doctor, I would like to ask about my condition. I underwent high ligation of the spermatic vein for varicocele at the end of June. I felt a significant improvement right after the surgery, but over the past two to three days, I've started to experience a dull ache in m...


Dr. Li Xinyi reply Urology
If there is a suspicion of recurrence, it is essential to undergo an examination, as recurrence is indeed possible. It is recommended to return for a follow-up appointment so that the surgeon can monitor the treatment.

[Read More] Understanding Recurrence After Varicocele Surgery: Symptoms and Concerns


Understanding Recurrence After Varicocele Surgery: Symptoms and Concerns

I underwent bilateral varicocele surgery at the end of May, and since the end of August, I have been experiencing swelling and pain in the right surgical site and groin area. However, there are no signs of wound dehiscence. I would like to know if this could indicate a recurrence...


Dr. Sun Hongshun reply Urology
Hello: Just because the wound hasn't opened doesn't mean there isn't an issue. Internal inflammation or soft tissue strain could be possible. It is recommended that you consult with the surgeon who performed your operation for an examination. Until a thorough evalu...

[Read More] Understanding Recurrence After Varicocele Surgery: Symptoms and Concerns


Understanding Post-Surgery Risks for Varicocele: Medication vs. Surgery

Hello doctor, I am troubled by varicocele. After consulting a physician, I was advised to undergo surgery, but one doctor suggested that I should take medication (for blood circulation) for three months first, as there may be swelling after the surgery. Others say that medication...


Dr. Xu Wencang reply Urology
Hello: In response to your question, the indications for surgery for varicocele are scrotal pain, infertility, and the appearance resembling a worm. If the criteria for surgery are met, the procedure should be performed without waiting for three months. Generally, there are no lo...

[Read More] Understanding Post-Surgery Risks for Varicocele: Medication vs. Surgery


Related FAQ

Varicocele

(Urology)

Post-Vasectomy

(Urology)

Post-Hernia Surgery

(Urology)

Vas Deferens

(Urology)

Phimosis

(Surgery)

Post-Electrocautery

(Urology)

Bleeding After Ejaculation

(Urology)

Epididymitis

(Urology)

Testicle

(Surgery)

Post-Anal Surgery

(Surgery)