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Is Surgery Only Solution For Varicocele?

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Posted on Mon, 2 Nov 2015
Question: Hi there,
I have admittedly been very anxious about a cluster of epididymal cysts with calcifications (found on both sides) and a small varicocele on the left side. I have been experiencing slight pain and overall discomfort since July 8, earlier this year. It took a while for me to work up the courage to call the doctor, but eventually a scrotal ultrasound confirmed these things. Right now I'm awaiting a consultation with a local urologist to figure out my best course of action. I am fully aware that the best course of action for these symptomatic cysts and varicocele is surgical removal and repair. The urologist I am to visit DOES specialize in "microsurgery" as well, and upon reading up on microsurgery, I understand it seems to be the safer route to go if I wish to maintain fertility. However, with this, I have a few questions that I simply cannot find the answer to online anywhere.
My main questions are as follows:
1- Is it possible to have both general and local anaesthesia for the surgery? I worry a lot about waking up in agonizing pain (as I've read can happen)
2- Is it possible that recovery time after microsurgery is faster than normal surgery due to it's delicate nature? (Though I'm not holding my breath on this one)
3- Would it be more beneficial for me to get these problems solved as soon as possible? In that, is recovery easier after a small cyst (you can't see mine for looking) is removed as compared to a larger one? Same with the varicocele?
4- IS there anything that can be given to me before the surgery to calm my anxiety and accept it more openly?
My scheduled urologist appointment isn't for another 2 months, however, I am on a waiting list to see if anything opens up sooner.
doctor
Answered by Dr. Dr. P. T. Patil (1 hour later)
Brief Answer:
You can safely go ahead and get operated without any tension ans anxiety.

Detailed Answer:
Hello
Thanks for writing again .I can understand your concern .

You have decided to go for surgery both for removal of Epididymal cysts and Varicocelectomy and have some fears in your mind pertaining to surgery and it's complications and recovery.
,
I would like to answer your queries point to point .

1) Normally this surgery is done under general anesthesia hence there is no question of pain during surgery .This being a microsurgery there will be a minimal handling of the spermatic cord,testicles etc so that the pain level after the surgery if measured on scale will not be more than 4 out of 10 which will be there for 12-24 hours and can be managed easily by pain killers in injectable form.

2) There is no doubt that recovery will be faster than conventional method because of minimal surgical trauma to the structures like spermatic cord,nerve and testicles etc.

3) Removing smaller cysts will help to have faster recovery than removing larger cysts which requires more dissection and since it is being done under microscope it will be much easier and faster .

4) Yes normally we give Alprazolam on previous night of surgery to allay anxiety and calm down patient's mind .

Do not worry and calm down ,I can understand your anxiety .

Hope I have answered your query ,please feel free to ask if you have more questions ,I shall be happy to help you
Thanks and Regards.
Dr.Patil





Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. P. T. Patil (1 hour later)
Thank you very much for your quick response, Dr. XXXXXXX As follow-up questions

1- This may sound silly, but what are the odds of stitches coming undone from the scrotum upon surgery? I'd like to think slim to none, but I have heard that this can potentially happen. The scrotum is very flexible, so is there any chance things could tear?

2- About the Aleve I'm taking, today will be day 8 of taking two per day (12 hours apart) It is helping with pain, but is there a point I should stop taking it due to potential health risks elsewhere?

I still have yet to see my urologist to discuss my options, but after your response, you've helped set my mind at ease. I'm almost certain I will choose microsurgery for both procedures.
doctor
Answered by Dr. Dr. P. T. Patil (1 hour later)
Brief Answer:
Scrotal incision never gapes away .

Detailed Answer:
Hello
Thanks for follow up .The scrotal skin heals within a week and never gapes away unless it gets infected .

You can take Alev that you are taking now .It is mild non steroidal anti infallmatory drug availavle freely over the counter .

Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. P. T. Patil (13 hours later)
What would be the reason for needing a scrotal drainage tube? Would that be a common thing to have after these particular microsurgical procedures? Or is that more of an open procedure thing?
doctor
Answered by Dr. Dr. P. T. Patil (8 hours later)
Brief Answer:
Normally no scrotal drainage is required

Detailed Answer:
Hello
Thanks for follow up .

Normally no scrotal drainage tube is placed .Do not get confused by surfing on internet .It is an open surgery done under magnification which helps to increase preciseness and minimal dissection during surgery .

Thanks and Regards.
Dr.Patil.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Dr. P. T. Patil

Urologist

Practicing since :1971

Answered : 10583 Questions

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Is Surgery Only Solution For Varicocele?

Brief Answer: You can safely go ahead and get operated without any tension ans anxiety. Detailed Answer: Hello Thanks for writing again .I can understand your concern . You have decided to go for surgery both for removal of Epididymal cysts and Varicocelectomy and have some fears in your mind pertaining to surgery and it's complications and recovery. , I would like to answer your queries point to point . 1) Normally this surgery is done under general anesthesia hence there is no question of pain during surgery .This being a microsurgery there will be a minimal handling of the spermatic cord,testicles etc so that the pain level after the surgery if measured on scale will not be more than 4 out of 10 which will be there for 12-24 hours and can be managed easily by pain killers in injectable form. 2) There is no doubt that recovery will be faster than conventional method because of minimal surgical trauma to the structures like spermatic cord,nerve and testicles etc. 3) Removing smaller cysts will help to have faster recovery than removing larger cysts which requires more dissection and since it is being done under microscope it will be much easier and faster . 4) Yes normally we give Alprazolam on previous night of surgery to allay anxiety and calm down patient's mind . Do not worry and calm down ,I can understand your anxiety . Hope I have answered your query ,please feel free to ask if you have more questions ,I shall be happy to help you Thanks and Regards. Dr.Patil