Surgical treatment of varicocele (Marmara operation)

Varicocele is a varicose veins of the spermatic cord. The disease is very common, can occur in 20% of men. Surgical treatment is recommended.
Varicocele is divided into:
• asymptomatic (ie, it does not bother the patient);
• symptomatic (aching and pulling pain in the scrotum, testicular atrophy (as a result of malnutrition), infertility (as a result of the fact that varicose veins disrupt the outflow of heat from the testicle, the temperature rises, and is disturbed, or the formation of sperm cells stops altogether).
Depending on the strength of the expansion of the veins, there are degrees of varicocele:
1 degree - the veins are not palpable by palpation, they can only be detected using ultrasound or Doppler;
2 degree - veins can be found in a standing position;
3 degree - veins can be found both in a standing position and in a sitting position;
Grade 4 - already during the initial examination with the naked eye, varicose veins are visible.

Most often, the Marmara method is used to treat left-sided varicocele. At first, the discomfort occurs after a long stay in a sitting position, and later, at rest, and intensifies when walking.
An indication for the appointment of surgical removal of veins can be:
 Severe pain in the testicle.
 Inability to conceive as a result of varicocele.
 Unaesthetic appearance.
 Delayed testicular development if varicocele is diagnosed in childhood.
 Surgical treatment of varicocele is carried out by several methods.

The spermatic cord is isolated through a micro-incision. Any dilated veins that surround the testicle are removed and tied. The wound is sutured in layers with a cosmetic suture.
The cost of the operation is due to the use of expensive microsurgical equipment. Non-obstructive methods are used to normalize venous outflow. Thus, artificial pathways for the outflow of blood from the testicle are created.
The Marmara operation is a microsurgical intervention that effectively eliminates the causes of male infertility: the incision does not exceed 2-3 cm in length and 3-4 cm in depth, the scar is not visually noticeable. Varicocele surgery using the Marmara method is performed using microsurgical instruments, which allows:
 Operate on an outpatient basis.
 Reduce the operation time and the rehabilitation period.
 Eliminate the risks of complications and relapses.
 Improve spermogram indicators and eliminate the impossibility of conception.

Varicocele surgery using the Marmara method is performed using microsurgical instruments, which allows:
 Operate on an outpatient basis.
 Reduce the operation time and the rehabilitation period.
 Eliminate the risks of complications and relapses.
 Improve spermogram indices and eliminate the impossibility of conception.
The Marmara operation is also distinguished by its efficiency - relapses occur in less than 5% of cases, while for other methods this figure exceeds 10%. Other benefits of treating varicocele using the Marmara method:
 minimal cosmetic defect;
 low risk of complications such as dropsy, scrotal hematoma, arterial damage;
 lack of significant discomfort in the postoperative period;
 fast recovery.

Microsurgical instruments are used: scalpel, catheter and others.

Surgery according to the Marmara method is considered the most modern way to eliminate varicocele. Therefore, in practice, our doctors prefer this particular method of treating this pathology.

In the first hours after the operation, the patient is under the supervision of a doctor in the recovery room. If the condition of the operated person is good, he is allowed to go home. The stitches are removed on the 7-8th day. Monitoring the condition and preventing complications immediately after surgery is necessary to ensure the normal course of recovery. For this, the patient spends some time in the clinic. In most cases, a course of therapy with non-steroidal anti-inflammatory drugs is prescribed.
After microsurgical intervention, the patient can return to normal life after 2 days. The exception at the recovery stage is heavy physical exertion and sexual intercourse, you should refrain from this for two weeks. After this time, it is recommended to gradually resume physical activity.

What other methods of surgical treatment of varicocele are there?
To remove the affected veins are used:
1. Operation according to Ivanissevich.
2. Operation Palomo.
3. Laparoscopic removal.
4. X-ray endovascular removal.
5. Operation on Marmara.
The most progressive method among the existing surgical methods for treating varicocele is the Marmara operation.
What are the contraindications to the surgical treatment of varicocele?
They are the same as for any planned surgical intervention:
• you cannot perform an operation in case of a viral or bacterial infection,
• condition after a heart attack and stroke,
• exacerbation of a chronic disease.
Tell your doctor if you are taking blood thinners or have allergies.

Indications

Varicose veins of the spermatic cord

Result

Surgical removal of varicocele. Before surgery: Dilated veins of the spermatic cord. After surgery: Improves sperm count and sex life. The possibility of infertility is eliminated.

Advantages of method

Минимальный косметический дефект; низкий риск осложнений в виде водянки, гематомы мошонки, повреждения артерий; отсутствие существенного дискомфорта в послеоперационный период; быстрое восстановление.

Instruments and equipments

Microsurgical instruments are used: scalpel, catheter and others.

Time of the surgery

Продолжительность процедуры

1.5 hours to 2.5 hours

Услуга	Цена, грн
Surgical treatment of varicocele (Marmara operation)	15 500

Нашеда Сергей Васильевич

Urologist, Surgeon Doctor of the highest category. 12 years of experience A urologist, surgeon has been working in the field of urology and andrology for more than ten years. Engaged in scientific activities, has the highest category in medicine. Surgical and conservative methods treat inflammatory diseases

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