Varicocele treatment: blocking the faulty veinVaricocele ka ilaaj: kharab nas ko band karna

Yeh kya hai aur kyun kiya jata hai

Varicocele us waqt hota hai jab testicle se khoon nikalne wali nasein phool jati hain, taang ki phooli hui nason (varicose veins) ki tarah (dekhein varicocele ki guide). Yeh baayen taraf zyada aam hai. Scan (scrotum ka ultrasound) is ki tasdeeq karta hai.

Ilaaj us waqt socha jata hai jab:

• yeh dard ya bhaari pan ka sabab ho jo aasaan tareeqon se theek na ho,
• kisi naujawan mein us taraf ka testicle doosre ke muqable mein theek se na barh raha ho,
• miyan biwi ko bachay mein mushkil ho aur semen test ghair mamooli ho, doosri wajuhaat dekhne ke baad (dekhein male infertility ki guide aur semen analysis ki guide).

Embolisation: radiologist (X-ray ka maahir) gardan ya groin ki nas mein patli nali daalta hai, use X-ray ki rehnumai mein kharab nas tak le jata hai aur chhote coils ya khaas liquid se band kar deta hai. Yeh sui ke suraakh se hota hai, scrotum mein cut nahi lagta.

Operation: surgeon groin mein ya us ke zara neeche chhote cut se kharab nasein baandh deta hai, aksar operating microscope ke saath taake artery aur lymph ki nalion ko bachaya ja sake. Kuch surgeon pait mein keyhole operation karte hain. Aap ki team batayegi ke aap ke liye kaun sa behtar hai aur yahan kya dastiyab hai.

Procedure se pehle

• Scan aur tests: ultrasound varicocele ki tasdeeq karta hai. Agar aulad ka masla ho to pehle aik ya zyada semen tests chahiye hote hain (dekhein semen analysis ki guide), aur aap ki biwi ka bhi muaina ho sakta hai.
• Peshab ka test ho sakta hai (dekhein peshab ke tests ki guide).
• Khoon patla karne wali dawayein, allergies (khaas tor par X-ray ke dye se) aur gurdon ke masail ke baare mein team ko batayein. Apne taur par koi dawa band na karein.
• Bay-hoshi: embolisation aam tor par local anaesthetic mein hota hai, kabhi sedation ke saath. Operation aam tor par poori ya spinal bay-hoshi mein, usi din ghar jane wale tareeqe se hota hai.
• Aap se razamandi (consent) maangi jayegi. Imaandari se poochhein ke dard ya aulad ke liye kya faida umeed rakhna chahiye, aur varicocele ke dobara aane ka kitna imkaan hai.

Procedure ke dauran

Embolisation: gardan ya groin ki nas ke upar ki jild sunn ki jati hai aur patli nali daali jati hai. X-ray tasveeron aur dye ki madad se radiologist kharab nas dhoondta hai aur use coils ya khaas liquid se band karta hai. Phir nali nikal li jati hai aur suraakh par dabao rakha jata hai. Aam tor par taqreeban aik ghanta lagta hai.

Operation: anaesthetic ke asar ke baad groin mein chhota cut lagaya jata hai, kharab nasein pehchan kar baandhi aur kati jati hain, aur cut ghulne wale taankon se band hota hai. Aam tor par taqreeban aik ghanta lagta hai.

Procedure ke baad aur recovery

Embolisation ke baad

• Aap thori der aaram karte hain aur aam tor par usi din ghar chale jate hain. Khud gaari chalate hue ghar na jayein.
• Suraakh ki jagah neel ya dard, aur chand din groin ya pehloo mein dard aam hai.
• Jaisa mashwara ho chand din bhaari wazan uthane aur zor wali kasrat se parhez karein.

Operation ke baad

• Aap aam tor par usi din ghar chale jate hain. Groin aur scrotum mein dard, neel aur kuch soojan aam hai aur do haftay mein theek ho jati hai.
• Sahara dene wala underwear pehnein aur aam dard ki dawayein lein. Zakhm ko jaisa mashwara ho saaf aur khushk rakhein.
• Takreeban do haftay, ya jaisa mashwara ho, bhaari wazan uthane aur zor wali kasrat se parhez karein. Gaari aur kaam ke baare mein poochh lein.

Mumkina khatrat aur kya umeed rakhein

• Ilaaj se woh nateeja nahi bhi mil sakta jis ki aap ko umeed ho. Dard hamesha door nahi hota, aur aulad ke liye faida ghair yaqeeni hai. Sperm banne mein taqreeban teen mahinay lagte hain, is liye koi tabdili zaahir hone mein kam az kam itna waqt lagta hai.
• Aam: chand din se do haftay tak neel, dard aur takleef.
• Kam aam: varicocele ka baaqi rehna ya dobara aa jana, aur zakhm ya suraakh ki jagah infection ya khoon.
• Operation ke baad: testicle ke ird gird paani jama ho sakta hai (hydrocele, dekhein hydrocele ki guide). Yeh us waqt kam mumkin hai jab operation microscope se ho.
• Bohat kam: testicle ki artery ko nuqsan jis se woh chhota ho sakta hai, X-ray dye se reaction, coil ka kisi aur jagah chale jana, taang ya phephre mein khoon ka lothra, ya anaesthetic ke khatrat.

Follow-up aur nateeje

• Follow-up: kuch haftay baad zakhm ka muaina ho sakta hai, ya team aap ko phone kar sakti hai.
• Agar ilaaj aulad ke liye tha to aam tor par takreeban teen mahinay ya zyada baad semen test dobara hota hai (dekhein semen analysis ki guide).
• Agar ilaaj dard ke liye tha to dard theek hone mein kuch haftay lag sakte hain. Agar na ho to apne urologist ko batayein.
• Nayi gaanth ya soojan ka muaina karwana chahiye (dekhein scrotum ki soojan ki guide).

Aam sawalaat

What it is and why it is done

A varicocele happens when the veins that drain blood from the testicle become swollen, a bit like varicose veins in the leg (see the varicocele guide). It is more common on the left side. A scan (ultrasound of the scrotum) confirms it.

Treatment is considered when:

• it causes pain or a heavy ache that does not settle with simple measures,
• in a teenager, the testicle on that side is not growing as well as the other,
• a couple are having difficulty conceiving and the semen test is abnormal, after other causes have been considered (see the male infertility guide and the semen analysis guide).

Embolisation: a radiologist (an X-ray specialist) passes a thin tube into a vein in the neck or groin, guides it under X-ray to the faulty vein, and blocks it with tiny coils or a special liquid. It is done through a needle puncture, with no cut in the scrotum.

Surgery: a surgeon ties off the faulty veins through a small cut in the groin or just below it, often using an operating microscope to protect the artery and the lymph channels. Some surgeons use keyhole surgery in the abdomen. Your team will explain which choice suits you and what is available locally.

Before the procedure

• Scan and tests: an ultrasound confirms the varicocele. If fertility is the concern, one or more semen tests are needed first (see the semen analysis guide), and your partner may also be checked.
• A urine test may be done (see the urine tests guide).
• Tell the team about blood thinners, allergies (especially to the X-ray dye) and any kidney problems. Please do not stop any medicine on your own.
• Anaesthetic: embolisation is usually done under local anaesthetic, sometimes with sedation. Surgery is usually under general or spinal anaesthetic, as a day case.
• You will be asked for consent. Please ask honestly what benefit to expect for pain or fertility, and the chance of the varicocele coming back.

During the procedure

Embolisation: the skin over a vein in the neck or groin is numbed and a thin tube is passed in. Using X-ray pictures and a dye, the radiologist finds the faulty vein and blocks it with coils or a special liquid. The tube is then removed and pressure is applied to the puncture. It usually takes about an hour.

Surgery: with the anaesthetic working, a small cut is made in the groin, the faulty veins are identified, tied and divided, and the cut is closed with dissolvable stitches. It usually takes about an hour.

After the procedure and recovery

After embolisation

• You rest for a short time and usually go home the same day. Do not drive yourself home.
• A bruise or ache at the puncture site, and an ache in the groin or flank for a few days, are common.
• Avoid heavy lifting and strenuous exercise for a few days, as advised.

After surgery

• You usually go home the same day. Groin and scrotal soreness, bruising and some swelling are common and settle over a couple of weeks.
• Wear supportive underwear and take simple painkillers. Keep the wound clean and dry as advised.
• Avoid heavy lifting and strenuous exercise for about two weeks, or as advised. Ask about driving and work.

Possible risks and what to expect

• Treatment may not give the result you hope for. It does not always relieve pain, and the benefit for fertility is uncertain. Sperm take about three months to be made, so any change takes at least that long to show.
• Common: bruising, soreness and discomfort for a few days to a couple of weeks.
• Less common: a varicocele that persists or comes back, and an infection or bleeding at the wound or puncture site.
• After surgery: a collection of fluid around the testicle (a hydrocele) can form (see the hydrocele guide). This is less likely when the operation is done with a microscope.
• Rare: damage to the artery to the testicle, which can shrink it, a reaction to the X-ray dye, a blocked coil moving to another place, a blood clot in the leg or lung, or the risks of the anaesthetic.

Follow-up and results

• Follow-up: you may be seen after some weeks to check the wound, or the team may call you.
• If treatment was for fertility, a semen test is usually repeated after about three months or more (see the semen analysis guide).
• If treatment was for pain, it can take some weeks for the ache to settle. Tell your urologist if it does not.
• A lump or swelling that is new should be checked (see the scrotal swelling guide).

Common questions