Microsurgical varicocele treatment (Marmar method)
One of the most efficient and safe ways to treat varicocele, particularly when it comes to preserving fertility and minimising the risks of recurrence.
Varicocele is a varicose dilation of the spermatic cord veins, which can lead to impaired spermatogenesis and infertility. It is diagnosed in 15-20% of men and in most cases requires surgical treatment.
Marmar surgery is considered the best treatment of varicocele as it eliminates the issue with minimal risk of complications and recurrences. The Marmar procedure is performed using a surgical microscope, which allows the surgeon to precisely isolate and ligate the damaged veins without affecting the surrounding tissue, nerves and lymph vessels. This is particularly important to prevent hydrocele (fluid accumulation in the testicular sheath) and varicocele recurrence.
Urologist consultation to ascertain treatment options. Scrotal ultrasound with Doppler scan. Spermogram to assess semen quality and sperm count. Common blood and urine tests, and a coagulogram. Electrocardiogram (ECG).
Marmar microsurgery for varicocele is performed under local anaesthesia and lasts about 1-2 hours. The doctor makes a small incision about 2-3 cm long in the area of the inguinal canal, just above the base of the penis. Using a surgical microscope, the surgeon isolates and ligates all visible dilated veins of the spermatic cord, leaving the arteries and lymphatic vessels intact. After ligating and crossing the dilated veins, the incision is sutured with cosmetic sutures and covered with a sterile dressing.
Surgical microscope for high precision manipulation on small vessels. Microsurgical instruments.
After the surgery, the patient is advised to rest and avoid physical exertion for several days, wear supportive undergarments to reduce discomfort and swelling, and take medications prescribed by the doctor. Sexual intercourse and strenuous exercise should be avoided for 2-4 weeks. Full fertility restoration may take several months, during which time it is recommended to see a urologist.
Benefits
High efficiency
Marmara surgery shows the best results in reducing relapses and improving fertility.
Minimal injury
A small incision and the use of microsurgical techniques minimize damage to surrounding tissues.
Short recovery period
Patients can return to normal life within 1-2 weeks.
Cosmetic effect
A small incision and careful suturing make the scar almost invisible.
Frequently Asked Questions
How quickly can sperm quality be expected to improve after Marmar surgery?
What are the risks of varicocele recurrence after Marmar surgery?
Is it safe to exercise after Marmar surgery?
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Urologist, Pediatric Urologist, Ultrasound Diagnostician
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