Varicocele

Patients should be reassured that if their varicocele is not causing any symptoms or problems then they do not need any active treatment.

Patients with mild discomfort should wear supportive briefs, rather than boxer shorts, before discussing more invasive treatment options.

Adolescents with a grade II or III varicocele that is not treated should be asked to return yearly for physical exam and check on testicular growth.[23]Macey MR, Owen RC, Ross SS, et al. Best practice in the diagnosis and treatment of varicocele in children and adolescents. Ther Adv Urol. 2018 Jun 22;10(9):273-82. https://journals.sagepub.com/doi/10.1177/1756287218783900 http://www.ncbi.nlm.nih.gov/pubmed/30116303?tool=bestpractice.com ​ Patients and parent or caregiver should be counseled about the potential for reduced fertility in later life if the varicocele is not treated.[53]Laven JS, Haans LC, Mali WP, et al. Effects of varicocele treatment in adolescents: a randomized study. Fertil Steril. 1992 Oct;58(4):756-62. http://www.ncbi.nlm.nih.gov/pubmed/1426322?tool=bestpractice.com ​ These patients should be informed to seek out a male fertility specialist if they are unable to conceive.

Postoperative measures

Routine postoperative care includes suitable analgesia and wearing supportive briefs, which may also help reduce pain by relieving pressure in the testicles.

Activity levels depend on the operative technique; however, most patients can return to nonstrenuous activities after 2 days and more strenuous activity (e.g., exercise) after 2 to 4 weeks. Patients should be told that improvements in sperm quality may take several months.