Why you should avoid varicocele surgery, if possible

In 2003, an lump appeared in my right inguinal area. Then, 2 weeks later i began to have pain at the top of my epididymis, the structure behind your testis.

Turns out the lump was a small hernia, and i was told the testicular pain was not related with the hernia.

Few month after i began to develop large varicose veins in both testis, more in left one, and severe discomfort increased by heat.

I have an history of urologic surgery for ureteral reimplantation at birth. I had frequent UTI as a child and urinary irritation growing up. I only found recently that grapefruit seed extract helped me a lot with that.

So, my GP sent me to send a urologist, who told me it was a simple procedure and as the discomfort was unbearable i jumped into the surgery.

Very bad idea since i developed chronic epididymitis on the right side. And the discomfort was not completely relieved. The bag of worm disappeared partly with time.


The surgery was very painful, with large scars. The surgeon did the incision over my previous bladder scars : looks like a c-scar. My scrotum was swollen, seemed to be congested, and within a week i was in the ER for acute right epididymitis. There everyone looked me like i had a STD, the surgeon wasn't available, and was a real piece of ass.

They failed to provide the appropriate antibiotic in time : fluroquinolone family are those you need in that case, even if some people badly react with them(google floxed for info).

I was really angry that i wasn't told about a non surgical alternative, called varicocele embolization.

You must know that with every surgery comes a risk of nerve injury, chronic pain, infection..

There a a lot a nerve in the inguinal region. If they damage the ilioinguinal nerve you could end up with neurologic testicular pain....

If they damage the vas deferens, maybe that's what happened to me, there is no way to know it. Nobody does defferentography anymore. You may end up with epididymal congestion pain as in post vasectomy pain syndrome.

By the way, if you have bad idea to have a vasectomy, don't do it ! Many guys end up in chronic pain. If it works don't fix it!!! Don't trust the surgeon, trust people experience. I still don't understand why people take such risks instead of using a stupid condom.

You should fully understand the procedure before having it.

So the general cause of varicocele is known to be spermatic vein incompetence, so they basically ligate or embolize it.  The collateral network should then do the job.

This is theory... But we are all different. Also some publications point out that spermatic vein is the culprit in 80% of varicocele, followed by cremasteric veins.

Also they never check for a nutcracker syndrome, in which the renal vein is compressed by an artery which cause varicocele too.

So if you are part of the 20 percent a healthy vein will be ligated for nothing.

Also if you have a weak venous system like me, you will always have problems.. Currently i still have subclinical varicocele, only seen during Ultrasound, but at the end of hot day, i can see them, and feel them....

Surgeon are always optimistic : "This is a begnin procedure..."

You will also here some : "Don't believe all the junk you read on internet". I agreed with that before, my two bad experiences with surgery. Believe me few surgeon are really skilled. If you live in a city like New York, you may find the best, but if you live in the country and go to your local hospital, expect the worst....

Few urologist really master the theory behind varicocele. Don't believe me ? Give you time and read every study about varicocele. You'll see a lot of difference between procedures. Some ligate only veins, some ligate arteries, and some say ligating artery will produce testicular atrophy : great ! Some also ligate lymphatics where some say you must preserve them to prevent hydrocele.

What i mean, is that there is nothing really clear. The more i read about the more i think i should have avoided that surgery. I should only have the left side repaired, not both.

And what will happen in case of recurrence, will they ligate every vein ?

How will the venous return occur then ?? The artery still pump the same amount of blood, but the veins won't be enough to drain that blood back. Imagine what happens next, varicocele reoccurrence, chronic pain...

12 years after this surgery, i noticed strange inguinal pain when sexually aroused. Seems like congestion to me...

I think the best method to treat is microsurgical varicocelectomy but only by a very good urologist, and lucky you if you find one in your area. If not they could damage a lot of important tissues, nerves, vas deferens.

Important : when you are in a situation like mine, you notice a lot of people are in the same boat, and few options are proposed by urologists(i've seen a lot!). For pain, if you have money you can have spermatic cord denervation, but it can fail, will cost you 10000$, will destroy cremasteric reflex(your balls will hang). For testicular heaviness, they will tell you subclinical varicocele should be left untreated, probably because a lot of people have side effect from varicocelectomy. For chronic inflammation, they have no idea. I was given 6 months antibiotics, but it failed.... Epididymectomy can worsen the pain, as the nerve can be damage or compressed by surgery, and also because testicle will continue to produce spermatozoids, but they will get trapped in the rete testis, provoking inflammation.

Embolization on the other side also depends on the radiologist experience. They put metallic coils in your vein, which in some person create a lot of pain. There's a Youtube video from a guy having them removed surgically because he was in pain...

But again they block the hole spermatic vein. In some people it is a real success, so if you have waited enough before correction and your quality of life is really lowered you still can give it a try. But again, choose an experienced practitioner : unfortunately difficult to know before.

Some people complain about increased varicocele after surgery. I guess these guys had the healthy vein embolized...

If you read this because of unfertility problems, and found my blog, here is my advice. If there is no discomfort in you groin please don't have surgery/embolization, change you lifestyle, eat antioxidants.... there's no coming back from a failed surgery. In that case you will lost your wife your job, and you are not even sure your wife will get pregnant. Living with chronic testicular pain will ruin every aspect of your life believe me. It's not like a pain in the arm or anything.

Surgeon are always confident, but when there is a problem no one is there to help.


So before doing anything, surgery or embolization, be sure you have tried everything else! In my case i'm sure my varicocele appeared because of chronic muscle strain due to my inguinal and testicular pain. Relax your muscle, don't smoke, drink less alcohol, use antioxidant, and any advice you can find on the internet, practice sport like swimming, but don't sit all the day : no luck i guess your job is forcing you to sit all the day in front of a computer... I eagerly regret what i did.

And guess what, one year later i had appendicitis... I'm sure there's a connection with the muscle strain from the previous surgery...

If you are not convinced and like to discuss don't hesitate to leave a message.