Men's Health Manhattan
115 East 57th Street, 4th Floor New York, NY 10022 +1 212-434-4650

Microsurgical Varicocelectomy

In this surgical procedure, patients receive general anesthesia. A 1 inch incision is made beneath the pubic hair line but above the scrotum. Using an operating microscope under significant operative magnification (usually 15x), we tie off and close the veins running with the spermatic cord, taking care to avoid injury to the delicate testicular/internal spermatic artery, the vas deferens and its vessels, and the lymphatic vessels. The operation takes about 1 hour per side that we treat (some men will require both sides treated). Patients go home the same day and are often back to work within a day or two. 

Benefits of this surgery in terms of sperm production will often take 3 to 6 months to become apparent, as sperm production takes about 3 months from start to finish. It is not uncommon for us to receive word by 3 months that pregnancy has been naturally conceived, often after months and years of waiting. 

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How is Microsurgical Varicocelectomy Performed?

In this surgical procedure, patients receive general anesthesia. A 1 inch incision is made beneath the pubic hair line but above the scrotum. Using an operating microscope under significant operative magnification (usually 15x), we tie off and close the veins running with the spermatic cord, taking care to avoid injury to the delicate testicular/internal spermatic artery, the vas deferens and its vessels, and the lymphatic vessels. The operation takes about 1 hour per side that we treat (some men will require both sides treated). Patients go home the same day and are often back to work within a day or two.

What are the Benefits of Microsurgical Varicocelectomy?

Benefits of this surgery in terms of sperm production will often take 3 to 6 months to become apparent. Sperm production in general takes about 3 months from start to finish. It is not uncommon for us to receive word by 3 months that pregnancy has been naturally conceived, even after years of waiting and trying various other treatments in the past. In addition, some couples who have failed IVF in the past will benefit from varicocelectomy, as improved semen parameters can lead to better IVF outcomes.

Are there Risks to Microsurgical Varicocelectomy?

This is generally considered a low risk surgery with a fast recovery and mild pain. Most patients are back to work within a day or two and are back to their usual activities, including gym and sports within a week. General risks of surgery including a rare infection risk and a rare risk of bleeding. It is extremely uncommon for this to have a negative effect on sperm production. In my experience, those rare instances with a short term decline in sperm production have invariably led to a rise in sperm numbers over the 6 to 12 month time course. There are uncommon patients who do not see much benefit from this procedure.

Is it Covered by Insurance?

Yes, this is almost always covered by insurance, making it a much less expensive treatment as compared to IVF, while curing the underlying source of the issue. In the rare instances where this is not covered, my office will provide you with a full understanding of the expenses associated with this procedure prior to your surgical date.

Why Men's Health Manhattan: Microsurgical Varicocelectomy

At Men’s Health Manhattan, we are proud to be leaders in the field of microsurgical varicocelectomy and have some of the highest surgical volumes in the New York area. Varicoceles are a normal variant of anatomy, but in a percentage of these have been proven to affect sperm production. Our robust experience has led to clear and proven improvements in men where the varicocele is the likely source of the production abnormality, and will often help couples to avoid costly IVF treatments.

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