Varicocele surgery: Preparation, Restoration, Long-term care

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Varicotomy is a surgery made for varicocele treatment, a state in which veins within the scrotum (called pampino-shaped plexus) become abnormalThe operation, as a rule, is carried out when the edema cause chronic pain or the adherence of men .While it is effective in facilitating the pain of the egg, it remains a significant debates as to how effective varicocell surgery is found in the restoration of male fertility.

What is the VARICOCELLIC SURGERY? .

Varicocele surgery, also known as varichotomy, describes three different surgical methods that are generally performed as an ambulatory manner .And men, and children can be candidates for treatment.

Each type of surgery aims to restore normal blood when testicular, block or cut from these increased veins.Restoration of the normal bloodstream, the environment around the egg is also becoming more favorable for the production of testosterone and hormone.Surgical options include:

  • microsurgical varicotomy : an open surgery , which comes to obstruction through the incision in the groin.The blood flow flow is redirected when the abnormal veins are fastened or tied.
  • Laparoscopic Varicotomy ‘

Percutaneous embolization : minimally invasive procedure,In which the narrow tube is fed through a vein on the neck or groin at the location of the veins on the testicles within the abdomen.Use of recreation of chemical products or small metallic coils, the veins are blocked so that the bloodstream can be rejected the normal veins. .It is known that microsurgical varicocellomy in the subsiginal section (lower part of the groin) has the best results and, therefore, is a method for choosing in the treatment of symptomatic varicocele.The operations are carried out by Yogs, and percutaneous embolization is carried out by interventional radiologists.

Getting information from Meds / Laura Porter

Contraindications

There are several absolute contraindications for varicocel surgery,Except those who are associated with surgery in its entirety (for example, the current infection, adverse reactions of anesthesia or strong malnutrition).

Not all varicolis require surgery.Most of the low-level varicocele will not have any symptoms or cause birth problems or hormonal levels. Experts show that the repair of the upper class of varicocellos has more benefits advantages.

The opinion of the Commission in 2014, issued by the American Society of Reproductive Medicine, is recommended against the operation in men with a low-quarter subclinical varicotter (which means varicocele, visible in ultrasound,But without excessive symptoms) or with symptoms, but ordinary sperm. In such cases, such as these, there is no clear evidence that the operation can improve the quality or amount of sperm.

People with varicocele, who will decide to treat the treatment of infertility, it is generally recommended to pass the varicotomy and not The embolization due to the excellent level of pregnancy.

Similarly, men are recommended with severe bilateral varicotse (varicocele value in both testicles ) For embolization due to a much greater level of failures.

Potential risks

As in all Operations Varicoscélical surgery is the risk of injury and complications.The most common are:

  • Hydrocelli (fluid extension around the testicles)
  • Post-Operational infection
  • Vascular drilling
  • Intestinal injury (mainly with laparoscopic varicotomy)
  • twIGRATION OF THE SCROTUM (caused by nervous damage)
  • Trombophleybitis (blood clot formation in Vienna)
  • Varicocelecelencence / Li>

Risks are significantly lower with open microsurgery , which are directed to the veins more selectively than laparoscopy or percutaneous embolization.

Objective

Varicocele is a general condition that affects 15% to 20% of all men and 40% of men with infertility. This can lead to pain and drive to a azoospermia (lack of mobile sperm) and egg atrophy (contraction).

Although the cause of the varicocele is not fully understood, it is believed that the size or geometry of the veins that serve the testicles, simply inadequately in some men, probably from birth.It can also be associated with failure within the pampino-shaped plexuses that are intended to prevent inverse blood flow.

Problem with Varicotter lies in the fact that the Pampinoid Plexus functions as a Testicles Temperature Regulator, keeping them 5 degrees under the body .When the veins are blocked or blocked, the reverse blood flow causes an increase in temperature, a decrease in the production of sperm and the amount of sperm.

Viricocele tends to influence the left testicle than to the right due to the address of the blood flow through the scrotum. Bilateral varicocele is extremely rare, but it can happen.

Chronic pain

Not all treatment of ViasticaSurgery can be considered if the varicocele causes chronic pain and conservative measures (such as anti-inflammatory drugs, class support, as well as activity limitations) can not provide relief.

Pain in varicocele, as a rule, begins before puberty and rarely resembles a new symptom in the elderly. The pain is generally described as a boring, pulsating and constant, and not acute or cooks.

If an operation is specified, the health provider will perform tests to eliminate other possible causes and characterize the Nature of pain.The study may include:

If the varicocele is aggravated by pain occurs in men who have been subjected to a vasectomy or processed for TA> Hernia Pughinal or have suffered other procedures in groin or testicles the health provider canChoose the sperm block (the inclusion of anesthesia injection on the cable where the pampinooid plexus is located).If there is an improvement in pain, then the microsurgical cable is denied and varicothotomotomy can be pursued instead of single varicocele only to constantly block pain signals. / P>

Effort of men

The treatment of male infertility with varicotic surgery remains contradictory.Depending on the surgical approach, the benefits of treatment do not always correspond to the improvement of pregnancy rates.

Due to these restrictions, ASRM approves the use of varicocele surgery, when most or the following conditions are performed:

  • couple tried and could not get pregnant,
  • Varicocele is in a physical examination.
  • The couple of woman has normal fertility or treatment potentially infertility .
  • The male companion has abnormal sperm parameters.
  • The time to conceive is not anxiety (for example, with younger couples, which may have more time to conceive than older couples).

The use of surgery varicocele in men with a neglected or subclinical varicopseer is the issue of discussions without restrictions.Although studies still offer consistent conclusions, the consideration of 2016 in fertility and infertility of suggests that it may be useful for men who decide to pursue in vitro fertilization (FIV) after surgery.

Pediatric

VARICOTIC SURGERY ADVANTAGES In children they are not as clear as they are in men.Although the offensive of symptoms is often determined in early adolescence, there is no guarantee that proactive treatment can overlook the future of infertility.

The Waricocele operation can be carried out in children with the following triad conditions:

  • chronic yachropean yachropeian
  • abnormal sperm parameters
  • > Progressive resolution of the size of the testicles (withA exceed 20% of interference) / Li>

, when some surgeons treat varicocellos Very large in children, despite the absence of pain or sperm anomalies, generally practice is discouraged.

How to cook

If it is recommended if the varicocele is recommended, it will meet with the UNEGE to qualified for the execution of the varicotomy or the interventional radiologist,Formed to perform percutaneous embolization. The specialist will pass through the procedure and tell you what he needs to do before and after the operation.

Varicocele surgery is performed at the Operating Hospital or in a Specialized Surgical Center. Surgical instruments vary according to the procedure and preferences and surgeon’s experience.Among them:

  • Microsurgical varicotomy is carried out with traditional surgical instruments and specialized microsurgical equipment, including a stereoscopic microscope (20X) or DA-The Robotic Vinci platform and the fault of microcicente tools
  • Laparoscopic surgery is carried out with narrow surgical equipment and a fibrous volume called laparoscope.
  • Expressive embolization is a directed procedure associated with the aged catheter and Viva X-ray images seen on the video monitor.

What to use

should be changed to a hospital dress for varicocel surgery, so We carry something, it is convenient that you can leave and come back easily. Leave the jewelry and other valuable things at home.

should also be prepared to eliminate points, dentures, hearing aids, silk and lip drilling or language before the operation, especially when passing a general anesthesia .

Food and Beverages

, if subjected to general anesthesia, regional anesthesia or form of intravenous sedation known as treatment with controlled medications (Mac) , you will need a period of publication,To avoid a pulmonary aspiration and asphyxia.

Some medications generally stop at any surgical procedure. For drugs that contribute to bleed, worsen the coagulation of blood or prevent healing.The most common include:

To avoid complications, inform your doctor about any medication you take, regardless of whether it is a recipe, an excessive table, nutrients, herbal or Recreation .

What to call

On the day of the operation, you must bring the license to drive, identification or other forms of government certificate.Also, bring your insurance card and the approved payment form if sustainability or costs or costs are required

you also need a friend or family member who sends home.Even if the procedure is done in local anesthesia, you should avoid unnecessary movements during the first or two days.

Most surgeons will be advised against driving or exploitation of heavy machinery during the first 24 hours.This is twice the truth if it has been subjected to an intravenous sedation or general anesthesia.

What to expect on the surgery day

Try to arrive at least 30 minutes before the appointment so you have a lot of time to register, complete the necessary forms and order any insurance problem.

Before surgery

As soon as Lace, head a surgical team member to a preliminary operating room and It provided a dress to the hospital to go.Prepared preparations may vary, but generally include:

The treatment area will also be launched and rinsed with antimicrobial detergent to the operation.

If you need to use General Anesthesia, Regional Anesthesia or Mac, you will meet with anesthesiologist to review your medical information, including any drug allergy or adverse reactions to anesthesia. , Maybe, I had in the past.

During surgery

As soon as it is prepared for the operation, it is administered in the Room and place operation in lying. Leader above) Position on the desktop.

The selection of anesthesia may vary depending on the procedure. Microscopic or laparoscopic surgery may include general anesthesia or regional block (for example, spinal anesthesia ). Percutaneous embolization is usually carried out in local anesthesia with or without Mac.

The choice of surgery is also varied according to the purposes of treatment.Among them:

  • Microscopic varicotomy considered treatment for infertility men.
  • Laparoscopic varicotomy Best suitable for teenagers, but it can also be used to treat pain or infertility of varicocel in men.
  • Expressive embolization less often used for the treatment of infertility, but may be ideal for men with varicovel pain, which can withstand anesthesia, or want to avoid more procedures invasive

While the objectives of several procedures are simlrot to redirect the blood flow to reduce venous swollen agents are very different .

microscopic varicotomomomomy

With the microscopic varicotomy, the urologist will access the pampino-shaped plexus through a section of a centimeter 3-5 on The inguinal channel, which is an edge of the seed.The cable rises and opens to open the sperm veins.

With a microscope and specialized surgical instruments, a urologist causes small clamps or seams for communication (close).After the bloodstream was clearly distracted, the surgeon closes and invigorates the wound. / P>

Laparoscopic varicotomy

for Laparoscopic varicothotomy, three ‘blocking wells’ is cut from 1 to 1.5 centimeters are performed at the bottom of the abdomen to accommodate laparoscope and the rest for the placement of forceps, retractors and other surgical equipment.

Before the belly ligature is pumped slightly by carbon dioxide to provide better access to the inguinal channels.As soon as the abnormal veins are exposed and linked (again with clamps or seams), the wound is firmware and is reinforced with tissue glue or small adhesive strips.

Percutaneous embolization

Before inserting a catheter (either through Vein Yapar neck or femoral veins foot), a contrast dye is introduced in the bloodstream,To help visualize the procedure through the X-ray technique in real time, known as fluoroscopy .

With a video device, the catheter feeds to the treatment site.But, instead of the linker vessels, the veins are scarce (scars) with a chemical or closed agent (blocked) with inter-metal coils. After rejecting the bloodstream, the catheter is removed and a small cut with adhesive stripes is sealed.

After the operation

After the operation, you control the recovery room until it is completely wake up and His vital vital signs returned to normal.Grugginity, fatigue and nausea are not uncommon, there may also be pain in a section.

Let the nurse present know that any of these symptoms is serious.If necessary, if necessary, a useless analgesic anesthetic, such as or medications against nausea (acetaminophen) or anti-nausea, as .

Once you are Stable enough to walk, you can return to your clothes and leave.Instructions for wound care will be provided.

Recovery

The recovery of varicochel surgery can be taken from one to two days for percutaneous embolization, two to four weeks for laparoscopic surgery,and from three to six weeks for open surgery.

Even so, most people can go back to work for several days. If your work includes a heavy increase, your health care provider may advise you to wait for more time.

Healing

When you return home from the operation, lie down as much as you can during the first 24 hours. In addition to Tilenol, you can treat the local pain and swelling with a cold compress . Bakers are also common.

Avoid injured wounds and regularly change the bandage according to the instructions of your medical care. When the soul, try not to start the wound and stroke (instead of NAT) the skin with a soft towel.When changing fuel replenishment, check any sign of infection and immediately call your doctor if symptoms are developed.

When calling your medical care

Call your health care provider, if any of the following options occurs in the following Waricocele operations:

  • at high temperature (more than 100.4 f) with oz rocks
  • Increased pain, swelling, redness,Heat or bleeding of the cut
  • DRAW Assignments of wound skirts
  • The wound begin to resume
  • Red striped source of the section

COPE with recovery

It is important to avoid rising heavier is 10 pounds for the first week. It also avoids intense physical activity (including cycling or execution) or until its health care providers give you ok.The redirection of the I can use coils or clamps and contribute to the formation of clots and thrombophlebitis.

With what he said, it is recommended to regularly walk to improve blood circulation and avoid constipation.Start slowly, increasing speed and duration gradually when it begins to treat.

Most men can return to normal sexual activity after a half or two weeks after permissive embolization and four to six weeks after varicotomy.Be sure to get everything in order your medical care before participating in sexual activity. Premature communication can lead to the rupture of the vessels, the recurrence of varicocele and other complications. .The negative is often unknown for reasons for recurrence.