What is Varicocele?

A varicocele is an abnormal enlargement of the veins within the scrotum that drain the testis — similar to varicose veins of the leg. It is found in 15% of all adult men and in 40% of infertile men — making it the single most common correctable cause of male infertility.

Varicoceles impair fertility by raising scrotal temperature, damaging sperm DNA and reducing testosterone production. They are graded I–III by clinical examination and ultrasound.

Symptoms

• Dull ache or heaviness in the scrotum — worse with prolonged standing
• Visible or palpable dilated veins ("bag of worms" feel)
• Reduced testicular size (atrophy) on the affected side
• Abnormal semen analysis — reduced count, motility, increased DNA fragmentation
• Often asymptomatic — found during infertility evaluation

Microsurgical Varicocelectomy

Microsurgical sub-inguinal varicocelectomy is the preferred surgical approach — performed under 2.5–4× magnification through a 2–3 cm incision. The dilated veins are tied off while preserving the testicular artery and lymphatics. It has the lowest recurrence rate (<1%) and lowest complication rate of all varicocele treatment approaches.

• Day-care or overnight procedure under local/spinal anaesthesia
• Return to desk work: 2–3 days; heavy lifting: 3–4 weeks
• Semen improvement in 60–70% of men within 3–6 months