Varicocele Repair Surgery (Varicocelectomy)

Varicocele repair surgery is a procedure to fix enlarged veins in the scrotum, called varicoceles. Think of a varicocele like varicose veins in a leg, but around the testicle. These swollen veins can cause a heavy, achy feeling, make the testicle run warmer than it should, and sometimes affect growth or sperm quality. During repair, the surgeon locates the problem veins and blocks them so blood takes a healthier path.

There are two main ways to do this.

• Surgical ligation: through a small incision (often in the lower abdomen or groin), the surgeon ties off the faulty veins under magnification (microsurgical or laparoscopic techniques).
• Embolization: through a tiny needle puncture in a vein (usually in the groin or neck), a radiologist threads a thin tube to the varicocele and plugs it from the inside with coils or special fluid.

Both approaches aim to reduce back‑flowing blood, cool the testicle to a more normal temperature, and relieve symptoms. The goal is better comfort, healthier testicular environment, and, when relevant, improved fertility potential—done with minimal cuts and usually as a same‑day procedure.

Shorter wait times

• Public queues for consults, ultrasounds, and OR time can be long. Private centres often arrange assessment and surgery within weeks—reducing time spent with aching, heaviness, and activity limits, and helping you get back to school, work, or training sooner.

Choice and control

• Choose a high‑volume surgeon with microsurgical or laparoscopic varicocele experience.
• Pick the clinic location (out‑of‑province) and schedule around exams, season play, or job demands.
• Discuss the approach that fits you best (microsurgical ligation vs embolisation) and anaesthesia preferences.

Peace of mind

• Clear timelines and a detailed plan—who’s operating, the technique, anaesthesia, and follow‑up—lower uncertainty.
• Direct messaging and prompt result sharing make it easier to coordinate rides, time off, and support.

Preventing further decline

• Persistent varicoceles can mean ongoing scrotal discomfort, testicular warmth, and, in some cases, slowed testicular growth or reduced sperm quality. Earlier repair may relieve symptoms and optimize future fertility potential.
• Fewer ER/clinic visits for flare‑ups and faster access to semen analysis and follow‑up imaging.

1. ‍Confirm your diagnosis. Most patients start with a family doctor or specialist who confirms that cystoscopy and/or surgery is advisable, but your urologist can also confirm if needed.

1. Research. Explore urologists who specialize in varicocle surgery.
   • You can find urologists in Vancouver, British Columbia; Calgary, Alberta; Toronto, Ontario; and Montréal, Québec on our app, and review qualifications, as well as pricing.
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2. Schedule an initial consultation. Most urologists offer in-clinic and online consults.
   
   • Consultations are usually booked within days or a few weeks.
   • Note: expect a consultation fee between $150 - $350.
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3. Consultation. The urologist will review your condition, symptoms, and any previous treatments or diagnostics, such as x-rays or MRIs.
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4. ‍Post consultation. The surgeon will then review your case and provide surgical options based on your needs; review the risks and expected outcomes; and present pricing and scheduling options.
   
   • Because the procedure is not covered by your provincial health plan when done privately, you’ll need to review the quoted cost and consider payment options (out-of-pocket, private insurance, or financing).
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5. Schedule your surgery date. Once you confirm the procedure and payment, the clinic will schedule your surgery—generally within a few weeks.
   
   • Plan for travel and accommodation, since the surgery will likely take place outside your home province.
   • Expect pre-surgery preparation, and possibly some pre-surgery tests.

Most varicocelectomies take about 45–90 minutes of operating time. Expect a few extra hours at the surgical centre for check‑in, anaesthesia, and recovery before you go home.

Basic steps (what actually happens)

Check‑in and plan

• You meet the team, review your ultrasound, and confirm whether the repair is on one side or both.

Anaesthesia

• You’ll usually have general anaesthesia (asleep). Some centres use spinal anaesthesia.

Position and prep

• You lie on a padded table. The groin/lower abdomen is cleaned and covered with sterile drapes.

Small incision

• The surgeon makes a short cut near the groin (inguinal or subinguinal).

Find the veins

• Under magnification (often an operating microscope), the surgeon carefully exposes the cord structures and identifies the enlarged veins.
• A tiny Doppler may be used to find and protect the testicular artery; lymphatic channels are preserved.

Fix the problem

• Faulty veins are tied or clipped (ligation) so blood stops pooling and reroutes through healthy pathways.

Check and tidy up

• Bleeding is controlled and the area is irrigated. The surgeon re‑checks artery flow and preserved structures.

Close up

• Layers are closed with dissolving stitches or sutures; a small dressing is applied. Supportive underwear is placed.

Wake‑up and instructions

• You recover in PACU, get simple after‑care instructions (support, icing, activity limits), and usually head home the same day.

Everyone heals differently—follow your surgeon’s plan. Varicocele repair is usually a same‑day procedure, but the area can be tender for a bit.

In general, what to expect

Days 1–3

• Reality check: groin/scrotum soreness, swelling, and a bruised look. Walking feels tight.
• Goals: control pain and swelling; keep the incision clean and dry.
• Activities: short walks around the house, scrotal support (snug briefs or a jockstrap), ice packs 15–20 minutes at a time, sit or lie with the scrotum supported. Avoid heavy lifting and straining.

Days 4–7

• Still annoying but improving.
• Goals: move comfortably and avoid pulling on the incision.
• Activities: light daily tasks and desk/school work as tolerated. Keep support underwear on. Quick showers are OK; no baths/hot tubs.

Weeks 2–4

• The steady phase.
• Goals: return to normal routines without swelling flares.
• Activities: gradually add easy cardio (walking, light bike). Most people can drive and do non‑physical work. No heavy lifting, sprinting, or contact sports yet. Sexual activity typically after your surgeon clears you (often around 2 weeks if comfortable).

Weeks 5–8

• Back to most activities.
• Goals: full comfort in daily life; begin heavier activity.
• Activities: ease into running, gym, and sport drills; lift progressively. Stop if you feel pulling or ache that lingers.

Red flags—call your care team

• Fever, worsening redness, pus, or spreading pain
• Scrotum suddenly much larger, very tight, or severely painful
• Persistent vomiting, trouble peeing, or calf/chest pain

Prices vary by province/clinic, anaesthesia, unilateral vs bilateral, and OR time. Ask for a written, itemised quote.

In Canada, private urology clinics charge $4,500–$16,000.

What’s usually included

• Surgeon fee
• Anaesthesia and monitoring (usually general, sometimes spinal)
• Accredited facility/OR fees, nursing, standard supplies
• Use of an operating microscope and/or Doppler (if part of the technique)
• Immediate recovery care and one routine post‑op visit

What’s often not included

• Initial consults and pre‑op tests (ultrasound, bloodwork)
• Extra OR time beyond the booked block or an unplanned overnight stay
• Prescriptions after surgery (pain meds, stool softener)
• Follow‑up semen analyses or additional imaging
• Travel/accommodation if you’re out‑of‑province/state

Tips to compare quotes

• Request line items for surgeon, facility, anaesthesia, and any microscope/Doppler fees.
• Confirm pricing for bilateral repair and what happens if more time or a second procedure is needed.

Getting to choose your urologist is one of the main benefits of pursuing private healthcare. Here's how to choose wisely.

What to look for

Experience and volume

• Ask how many varicocelectomies they do per month/year and what proportion are microsurgical (subinguinal/inguinal) versus laparoscopic.
• Higher volume and a standard same‑day pathway usually mean smoother care.

Credentials and training

• Verify licensure with your provincial college (CPSO Ontario, CPSBC BC, CPSA Alberta, CMQ Québec, etc.).
• Look for FRCSC‑certified urologists. Microsurgical fellowship or specific training in male fertility is a plus.

Technique and tools

• Do they use an operating microscope and micro‑Doppler to identify the artery and lymphatics?
• Ask about their approach for bilateral cases and how they reduce recurrence and hydrocele risk.

Outcomes and safety

• Request recent metrics: unplanned ER/clinic returns within 30 days, infection rate, hematoma rate, hydrocele rate, and recurrence/persistence rate.
• Ask how often they convert plans mid‑procedure and how that’s handled.

Pre‑op and after‑care

• Clear plan for ultrasound review, semen analysis (if fertility is a goal), and medication holds.
• Written after‑care, direct contact for urgent issues, and scheduled follow‑ups. When do they typically repeat semen testing?

Facility quality

• Accredited non‑hospital surgical facility (Accreditation Canada/CAAASF or provincial program), modern sterilisation, and hospital transfer agreements.
• Consistent anaesthesia coverage and availability of necessary equipment.

Pricing transparency

• Ask for an itemised quote: surgeon, facility, anaesthesia, microscope/Doppler fees, and follow‑ups.
• Clarify costs for bilateral repair, extra OR time, or unexpected overnight stay.

Questions to ask during your varicocelectomy consultation

Surgeon and surgical plan

• How many microsurgical varicocelectomies do you perform yearly? What are your recurrence and hydrocele rates in the last 12–24 months?
• Which approach do you recommend for me (subinguinal vs inguinal vs laparoscopic) and why?
• Will you use a microscope and micro‑Doppler to identify and protect the artery and lymphatics?
• If you find something unexpected (e.g., additional veins, hernia), how will that change the plan and risks?

Anaesthesia and logistics

• What anaesthesia do you recommend (general vs spinal)? What’s the pain‑control plan after?
• Is this guaranteed same‑day discharge, or could I need an overnight stay?

Recovery and follow‑up

• When can I return to school/desk work, light exercise, heavier workouts, and contact sports?
• How long should I wear supportive underwear? Any lifting limits?
• What red flags should prompt a call or ER visit?
• If fertility is a goal, when do we repeat semen analysis, and what changes are realistic?

Costs and documentation

• What exactly is included in my quote (surgeon, facility, anaesthesia, microscope/Doppler, dressings, first follow‑up)?
• What could add cost (bilateral repair, longer OR time, complications)? How do you handle consent and pricing if the plan changes mid‑procedure?
• Will I receive the operative note and a written after‑care plan?

Signals of a high‑quality program

• Shares outcomes data openly, uses microscope and Doppler routinely, provides clear after‑care and rapid access for questions, and offers transparent, itemized pricing.