# :rant: Varicoceles - what the Urologist didn't tell us...



## isaberg (Oct 2, 2002)

I thought I would put this up as general info, because I wish someone had told us...

We had secondary infertility. After more than two years of charting and acupunture and such, I did all my tests, and was fine, DH went to the urologist, and found out he had a varicocele and his sperm count was really low. A big one. Dr. says that the only way to take care of it is to have surgery. Guess what, he's a surgeon.

Surgery requires full sedation, cutting, a fair amount of pain, some scary potential side effects, and weeks of healing, and even then it might not improve fertility. We decide that we're not willing to go through with that. We settle down to working on an adoption instead.

So a full year later, the husband is doing some research on the web, and finds out that there's an alternate treatment for varicoceles, called embolization. It's outpatient surgery, doesn't require general anesthesia (though they drug you up enough that you don't remember what happens) doesn't have much in the way of side effects, and you can go back to work the next day or the day after. And to top it all off, it's way cheaper. (Like the surgery, there's still no guarantee that it will improve fertility, though it often does.) But it turns out that this is done by radiologists, not surgeons. So, apparently, most urologists, who are also surgeons, don't tell anyone about it.

This makes me hopping mad. We wasted a whole *^&*&^ year. What kind of doctors won't tell patients about a very clearly better, safer, much less painful treatment? Shouldn't that be ILLEGAL?

To make a long story short, he found mention of a local hospital that does this, and just set up an appointment with a doctor who does dozens of similar surgeries every month. They didn't ask for a referral at all. And we weren't about to demand one from the *&^&^ urologist. A month later DH had the embolization done, was in the hospital less than eight hours, went back to work the next day, and just had a little bit of aching for a week or so. We still don't know whether he has his fertility back - we have to wait another month.

So since I can't go yell at that urologist, and I can't get back that extra year, I'm posting this here, in the hopes that it will help out someone else.

-L


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## kristenok18 (Jun 26, 2006)

Wow....I had no idea! My dh has a varicocele, though they don't know if that's what is causing his problems or not. His dr was wishy-washy about surgery, but said he would be happy to do it if it's what we want. I have read that sometimes surgery is NOT the best option, so I was hesitant, but no one ever mentioned this other proccedure.







: Off to research now....


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## JennP (May 4, 2004)

Dh had bi-lateral varicoceles. That is in both testes. He had a procedure called bilateral varicocele tubal laperoscopy. This was very effective. Creating sperm is a 3 month process start to finish and we were pregnant 3 months after the procedure.

This is done by a surgeon (urologist) and was outpatient, he was intubated but the 3 incisions were very small and in his tummy area. He layed around for a couple of days as he was tender BUT he was back to work on Monday and fine. he had the procedure on Friday so he had some extra time off.

One Dr said that if the varicocels were NOT bi-lateral it may not effect the
overall fertiliy.

Good luck
Jenn


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## amy9798 (Jun 25, 2005)

That really stinks! You have every right to feel very angry!

We too dealt with secondary infertility for several years between #1 and #2 which turned out to be a large varicocele. Dh had the embolization in October 2002 and our second baby was born in October 2003. We waited the 3 months they suggest before ttc and then got pregnant on our first try. Baby #3 was also conceived on the first try. I like to think that our years of infertility kept a space open in our family for DS1, who we adopted this year.

Best wishes


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## bellymad (Jan 26, 2008)

Hi.

I want to find out if anybody had Varicoceles Surgery or embolization done in last 1-2 year. My husband and I have been debating which one is a better option. Urologist never told us that there was another option other than surgery. It's been one year since we have been waiting to get the surgery done. Now we came across an article about embolization on the internet. my husband is afraid to go back to urologist for the surgery as urologist never mentioned about embolization and also the side effects are more serious than embolization.

His sperm count is 15 million and motility is only 5%. I am not sure if embolization is safer than surgery and would any of these would really help infertility? Would it really improve sperm parameters? He is 34 and I am 28.
Is it worth it to wait and see the results of varicocele repair for another year or more, Or should I just go for IVF? Please advice.

Thanks!!


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## mclisa (Jul 26, 2004)

Perhaps the uro didn't know they were doing this technique nearby?


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## LW05 (Jan 28, 2008)

I know what you all are going through. My husband and i tried for 2 years to get pregnant. Finally, in July I went to the doc and everything seemed fine with me so he sent me home with a semen analysis specimen cup for my husband. We did 2 semen analyses and both were zero sperm counts. My husband has a varicocele. He had an ultrasound which showed the varicocele was a grade III (large). We saw a urologist in September and scheduled a varicocelectomy and a testicular biopsy for January. My husband had surgery 3 days ago. We won't know the biopsy results for 12 more days. The doc told me after the varicocelectomy that my husband had 5 dilated veins that they tied-off (vein ligation). He said most patients with varicoceles have 2 or 3. I am hoping and praying that maybe the varicocelectomy has solved our problem, especially since there were 5 dilated veins. But I have also heard from 2 docs that varicoceles usually cause low sperm counts and should not cause zero sperm counts. We are both in good health and young - both 26. It is very hard, especially because you have to wait so long for everything. We will know the bx results in a little less than 2 weeks now and my husband is suppose to give 2 more semen analyses, one at 3 months and one at 6 months to see if there is a sperm count yet. He is very sore still and not moving to well, but we figure if it works, it will all be worth it. Does anyone know if with him having 5 dilated veins fixed, is there a better chance for a sperm count now?? I will keep you posted. Good luck to all!!


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## isaberg (Oct 2, 2002)

Quote:


Originally Posted by *bellymad* 
Hi.

Is it worth it to wait and see the results of varicocele repair for another year or more, Or should I just go for IVF? Please advice.

Thanks!!

Unfortunately, that's something only you can decide; it's just a whole bunch of tradeoffs - time vs money vs who has to go through medical procedures vs your sense of how intense you want to get at this point. We chose to try the embolization because I'm just 31, so if it didn't work we had plenty of time, and because we're in the middle of an adoption, so we didn't really want to get any more intense with the infertility stuff.

DH went back to work the day after the procedure, but he said the varicocele area ached on and off for a couple months. Nothing painful, just a bit achy. And you don't wait a year to find out, just 72 days (how long it takes sperm to be made).

Quote:

Perhaps the uro didn't know they were doing this technique nearby?
I think that's very generous thinking, but doubtful. Radiologists aren't really in short supply, and this isn't a new/untested/rare procedure. It all comes down to territory and bias - if you're a surgeon (like most urologists) you're going to think that surgery is almost always the best option. The surgery costs more then the embolization. Most Urologist practices don't have a radiologist, so if you want the emb. the money goes elsewhere.

I like to think the best of people too, but the system is broken. Midwives tend to be cheaper, too, but you don't see doctors referring people to them. I think this instance is directly comparable.


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## airmide_m (May 8, 2006)

Thank you all so much for this information! I am bumping and subbing in case we need to know this soon (Got a fertility urologist appointment Feb 7th)


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