Post-Surgery Care and Exercise Guidelines for Varicocele Patients - Urology

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Postoperative varicocele?


Hello, Doctor.
I am 30 years old and underwent traditional high ligation surgery for varicocele for the first time last year.
Seven months later, I experienced a recurrence, with the varicocele still swollen, heavy, and painful, resembling a "worm" without any regression.
An ultrasound confirmed the recurrence, and last month I had a second surgery, a microsurgical procedure, where the doctor ligated 10 swollen veins.
It has been just over a month since the surgery, and I am currently recovering well (the "worm" appearance seems to be gradually shrinking).
However, sometimes after doing DIY activities, if I stand for a while, I feel some discomfort, and when sitting, I experience a slight pressure sensation in the testicles (should I consider the frequency of DIY activities to avoid excessive blood flow to the postoperative veins, which could lead to adverse outcomes?).

Additionally, I have a question regarding the restriction on lifting heavy objects to prevent recurrence.
My current job involves prolonged sitting, and since the first surgery, I have noticed a decline in my overall circulation and fitness.
I would like to resume my previous habit of exercising at the gym, but weightlifting is typically involved.
Is it acceptable to use equipment such as lying bench presses (Smith machine) for chest and fitness training? Also, can I use seated cable pulldown machines for back training, or seated rowing machines for back exercises, even if my abdomen engages slightly? The primary focus would be on my back muscles.
Can I use the aforementioned equipment to avoid simply lifting heavy weights while still maintaining my fitness and preventing a recurrence of varicocele? Or should I completely avoid weight training for six months and focus solely on walking to improve circulation? Thank you for your answers.
Here are the links to the exercise videos: 1.
http://www.youtube.com/watch?v=mM5lR12XvJU 2.
http://www.youtube.com/watch?v=BnLNWxW_DmQ 3.
http://www.youtube.com/watch?v=RxGXUdLaUdk

K, 30~39 year old female. Ask Date: 2013/09/05

Dr. Xu Weikai reply Urology


K: Hello, actually, varicocele is a localized swelling caused by poor blood flow.
When abdominal pressure increases, it raises the pressure on the venous return, thereby affecting the degree of varicosity.
After surgery, theoretically, the affected veins are ligated, and these veins will gradually shrink over approximately six months.
However, if abdominal pressure increases, previously small veins may gradually become varicose due to prolonged high pressure.
I cannot determine whether your exercise will have an impact; I can only say that minimizing abdominal pressure will reduce the recurrence rate.
If there are any unclear points, feel free to ask again, and we can discuss and research further.
Responses on the internet should only be used as a reference; if necessary, it is best to seek medical attention at a healthcare facility.
This message is from Dr.
Hsu Wei-Kai, Chief of Urology, Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2013/09/05

More Info


Post-surgery care and exercise guidelines for patients who have undergone varicocele surgery are crucial for ensuring proper recovery and minimizing the risk of recurrence. Varicocele surgery, whether traditional or microsurgical, aims to alleviate symptoms associated with enlarged veins in the scrotum, which can lead to discomfort and potential fertility issues. Given your recent surgery and the concerns you’ve raised, let’s delve into the recommended post-operative care and exercise strategies.


Post-Surgery Care
1. Rest and Recovery: After surgery, it is essential to allow your body time to heal. While you may feel good after a month, it’s important to listen to your body. Avoid strenuous activities, including heavy lifting and intense workouts, for at least six weeks post-surgery. This period allows the surgical site to heal properly and reduces the risk of complications.

2. Pain Management: It’s common to experience some discomfort post-surgery. Over-the-counter pain relievers can help manage this. However, if you experience severe pain or swelling, consult your healthcare provider.

3. Monitoring Symptoms: Keep an eye on any unusual symptoms, such as increased swelling, persistent pain, or signs of infection (redness, warmth, or discharge at the surgical site). If you notice any of these, seek medical advice promptly.

4. Avoiding Strain: As you mentioned, activities that involve prolonged standing or sitting can lead to discomfort. It’s advisable to take breaks and change positions frequently to alleviate pressure on the surgical area.


Exercise Guidelines
1. Gradual Return to Activity: After the initial recovery period, you can gradually reintroduce physical activity. Start with light activities such as walking, which can help improve circulation without putting undue stress on the surgical site.

2. Strength Training Considerations: While you may be eager to return to the gym, it’s crucial to approach strength training cautiously. Avoid heavy lifting for at least six months post-surgery. Instead, focus on lighter weights and higher repetitions to maintain muscle tone without straining the veins.

3. Safe Exercises: The exercises you mentioned, such as lying chest presses (Smith machine) and seated cable rows, can be suitable as long as you ensure that the weights are manageable and do not cause discomfort. It’s essential to maintain proper form and avoid any movements that put excessive pressure on the abdomen or pelvic area.

4. Core Stability: Incorporating core stability exercises can be beneficial. Strengthening your core can help support your pelvic region and reduce strain on the veins. Consider exercises like pelvic tilts or gentle abdominal contractions, avoiding any that cause discomfort.

5. Listen to Your Body: Pay attention to how your body responds during and after exercise. If you experience any discomfort, especially in the groin or scrotal area, it’s advisable to stop and consult your healthcare provider.

6. Consultation with a Specialist: Before starting any new exercise regimen, especially after surgery, it’s wise to consult with your surgeon or a physical therapist. They can provide personalized recommendations based on your specific situation and recovery progress.


Conclusion
In summary, while it’s important to maintain physical activity post-varicocele surgery, it’s equally crucial to approach your recovery with caution. Gradually reintroducing exercise, focusing on lighter weights, and prioritizing core stability can help you regain your fitness without risking recurrence of varicocele. Always keep communication open with your healthcare provider to ensure your recovery is on track and to address any concerns you may have. By following these guidelines, you can work towards restoring your physical health while minimizing the risk of complications.

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