What are Varicocele Procedures?
Varicocele procedures are used to correct a varicocele, a condition where the veins in the scrotum become enlarged, causing discomfort or, in some cases, affecting fertility later in life. In children and adolescents, surgical intervention is often recommended when the varicocele causes pain or does not resolve on its own. There are two primary approaches to treating a varicocele: surgery and interventional radiology. Your paediatric surgeon will discuss the best option for your child’s condition.
Types of Varicocele Surgery
There are different methods to treat varicoceles surgically or through interventional radiology. Your surgeon will help guide you in choosing the best approach. Common surgical options include:
- Laparoscopic (Keyhole) Surgery: A minimally invasive procedure where small incisions are made in the abdomen, and the testicular veins are clipped to stop blood flow, reducing the size of the varicocele.
- Open Surgery: This involves a small incision in the groin area to tie off the enlarged veins, improving blood flow away from the scrotum.
- Interventional Radiology (Embolisation): In this less invasive option, a small coil or embolic agent is inserted through a catheter into the vein, blocking blood flow to the varicocele. It is performed by a radiologist under imaging guidance.
How Long Does the Operation Take?
The surgery itself usually takes about 30 minutes.
Including time for administering and recovering from anaesthesia, your child will be away for around an hour.
Once they are in the recovery room, you will be called to join them.
How Do I Choose Which Procedure?
Your paediatric surgeon will help you determine which option is best for your child based on their individual condition, and recovery times from the different approaches.
Risks of Varicocele Surgery
Like any surgical procedure, varicocele surgery carries some risks, which will be discussed with you by your surgeon. These risks vary slightly depending on the type of procedure used.
Laparoscopic Surgery Risks:
- Recurrence of the varicocele
- Injury to internal abdominal or scrotal structures
- Infection, bleeding, or bruising in the abdominal area
- Hydrocele: Around 15% of cases may develop a hydrocele (fluid collection in the scrotum), which could require additional surgery.
Interventional Radiology (Embolisation) Risks:
- Minor wound issues at the catheter insertion site
- Recurrence of the varicocele
- Pain, which usually subsides with time
- Coil displacement, although this is rare
Recovery After Varicocele Surgery
After surgery, your child will rest in the recovery room as the anaesthesia wears off. Once your child is awake and comfortable, they can have a light snack or meal. You will likely be able to take them home within a few hours.
Wound Care and Dressings
For laparoscopic procedures, there will be small incisions in the abdomen with dissolvable stitches and waterproof dressings. The dressings can be removed after about a week. For embolisation procedures, there will be a small puncture wound at the catheter insertion site, which will also be dressed.
To help with healing:
- Keep the wound area clean and dry.
- Avoid bathing or showering until the dressing is removed.
- Contact your GP or surgeon if you notice any signs of infection, such as redness, swelling, or discharge.
Pain Relief
Your child will receive pain relief during the surgery, which will last several hours afterward. Once at home, they may need paracetamol (e.g. Panadol) or ibuprofen (e.g. Nurofen) for a few days. Please let your surgeon and anaesthetist know if your child has intolerances or allergies.
You can also help manage discomfort by distracting your child with quiet activities like reading, drawing, or playing games. Keeping their mind off the surgical site can reduce the need for additional medication.
Activity Restrictions After Surgery
After surgery, your child will need to limit their activity to allow proper healing:
- Bathing: They can bathe or shower the day after surgery
- Swimming: Swimming should be avoided for at least one week.
- School or Daycare: Your child can typically return to school or daycare after 5-7 days.
- Sports and Physical Activity: Avoid all strenuous physical activity, such as sports, for about 2-3 weeks to allow full recovery.
Troubleshooting Common Issues After Surgery
Pain
It is uncommon for significant pain that is not controlled with simple pain killers like paracetamol and ibuprofen. Call your surgeon or the day unit for further advice.
Is there a wound infection?
Infections can develop around 2-4 days after the operation and are a fairly uncommon issue.
The wound may be infected if there is increasing redness around the wound and tenderness. This may be associated with discharge from the wound site.
You will need to see your family doctor or call your surgeon for further advice.
It is very swollen - has it recurred?
It is normal for the area to become swollen after the operation, usually for a few days.
If your child has increasing pain, tenderness and vomiting associated with a similar bulge to before the operation there may be recurrence.
If your child is unwell in addition to these symptoms, you may need to go to the emergency department. Call your surgeon and let them know.
Otherwise see your GP and call your surgeon so your child can be assessed.
When to Seek Medical Attention
You know your child best. If you notice any unusual symptoms or have concerns, please contact your family doctor or surgeon. It’s important to get medical help if your child experiences:
- Persistent or worsening pain despite taking pain relief
- Increasing swelling or bulge – possible recurrence
- Fever higher than 38.2°C
- Vomiting or difficulty feeding
- Discharge or bleeding from the wound site
- No bowel movement after three days
Image Gallery for Patient Consultations
Our Paediatric Surgeons may use this image set during your consultation to explain conditions and treatments.
We welcome our referrers and other health professionals in the community to use these as well.
