A varicocele is an enlargement of the veins surrounding the testicle from impaired drainage and can be associated with infertility, abnormal semen parameters, testicular discomfort, low testosterone, and impaired testicular development. Microsurgical varicocelectomy is used to treat clinically significant varicoceles in appropriately selected patients.

Through a small incision in the groin, the spermatic cord is brought into view and the abnormal veins are identified and divided using an operating microscope. The testicular artery, lymphatic vessels, vas deferens, and other important structures are carefully preserved.

Treatment can improve semen parameters in many men and may improve the likelihood of pregnancy in appropriately selected infertile couples, both via spontaneous conception and IVF outcomes. Improvement in semen quality generally takes several months because sperm production requires approximately 2–3 months, and improvement can continue up to 12 months post-operatively.

The procedure is usually outpatient. Most men return to light activities within several days and avoid heavy lifting or strenuous exercise for approximately 2 weeks. Risks include recurrence, hydrocele formation, infection, bleeding, testicular injury, and persistent pain, although microsurgical techniques are associated with low complication rates.