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Hello I recently had a varicocele surgery (Microscopic, Inguinal) on 4/13/2013. The surgery was done to preempt any infertility issues due to bad counts.
After the surgery, the veins are larger than they have ever been before.
I am concerned that the surgery did not fully shut off the problem veins because the doctor only ligated one vein because he said he did not see any others.
During the standing position the varicocele veins are swollen and clearly full of blood that is not making its way back to the heart. I understand that this is expected post surgery as the blood will take time to find other non problem veins to flow through, assuming the path has been fully shut off.
However, after laying down for a few moment, the swollen varicocele veins reduce in size by about 90%. This indicates that all possible flow paths through the problem veins were not ligated. If the one vein that was ligated did indeed close off the entire flow path, then the veins would remain swollen in both the standing and laying down position because there would be no where for the blood to go.
This also tells me that even if the one ligated vein was the main problem, the remaining unligated veins are unable to clear the blood flow. It doesn't seem like the blood would need time to find these paths since they were already being used before the surgery.
If you agree, could you lend me your thoughts on what can be done to rectify the situation? Best to do surgery (what kind) or emobolization? If I did do embolization, could the fact that one vein is already ligated give the embolization a better chance at success?
If you do not think the surgery was unsuccessful and think the varicocele could still go away with time, could you let me know why you think this?
Could erectile dis-function be a sideffect? My testis were examined today and are said to be OK. Been under a lot of anxiety and I have not received a morning erection like I use to b4 surgery.
Well, without knowing the relevant clinical details or a detailed clinical evaluation it would be difficult to comment specifically on the situation. The prognosis after the surgery would depend on the initial grade of the varicocoele, the type of surgery done etc. Embolisation may have better chance at success, though it may not particularly be required. Erectile dysfunction is unlikely to be a direct side effect of the condition or the surgery. I would suggest discussing the situation, the suggested management plan and the expected prognosis in detail with your treating urologist.
Hope this is helpful.
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