Varicocele Repair

anatomy varicocele


The blood supply of the testicle is composed of one or more arteries that travel within the spermatic cord to deliver blood to the testicles and a plexus of veins that drain blood from the testicle. The anatomy of the testicle is maximized to allow a lower temperature than body temperature for sperm development.

To accomplish this feat, the testicles are present in a scrotum to help it keep it out of the body. Also, the blood supply is designed so that heat from the arteries to the testicles can be cooled by the complex of veins that run in the opposite direction.

The veins of the testicle, as in the veins of many of the parts of the body, are equipped with valves that prevent the blood from traveling downward with gravity. When these valves become incompetent, the veins can become enlarged and this phenomenon is commonly seen as varicose veins in the legs.  When this occurs in the testicle, it is believed to potentially lead to temperature as well as hormonal abnormalities which can influence sperm quality.

Most commonly, varicoceles will create abnormalities in the number of sperm moving, or motility, but can also manifest as changes in the shape of the sperm or lower sperm overall concentration.  Some men will be advised to have these varicoceles repaired in an effort to improve their semen parameters.  Not all men, however, are considered good candidates and this approach is not appropriate for all couples trying to conceive.

In our practice we perform a subinguinal microscopic or robotic varicocelectomy. In either approach, incisions are made in the lower groin to access the spermatic cord(s) which is then closely evaluated either under microscope or under a high-definition robotic camera to identify the enlarged veins. 

Care is taken to avoid damage to the arteries or to the lymph channels of the spermatic cord as well the vas deferens while the enlarged veins are carefully tied up. This is an outpatient procedure that generally takes about 2 hours.  It is frequently performed on both sides when varicoceles are detected. Semen analysis improvement is generally expected within three to six months and this treatment can be done in conjunction with hormone treatment, if indicated.  

Some patients are chosen to be good candidates for a microscopic approach while other may be deemed appropriate for a robotic assisted approach.  The anatomy of the patient will dictate which treatment option is best.


 "The procedure was over so quickly, I couldn't believe it." Lawrence S.
 "I was so worried about having a vasectomy for so long and Dr. Mistry made it effortless." Jinh J. 
 "Having the consultation and vasectomy in one visit was very convenient." Jon D.

Surgery Downloads

 pdf New Patient Packet
 pdf Da Vinci Prostatectomy Consent
 pdf Stent Placement Consent
 pdf TURP
 pdf Varicocle Repair Consent
 pdf Extracorporeal Shock Wave Lithotripsy (ESWL)
 pdf Hydrocele Repair Consent
 pdf Nephrectomy Consent
 pdf Ureteroscopy

Contact Us


Round Rock Location

970 Hester's Crossing Road
Suite 101
Round Rock,TX 78681

Phone 512-238-0762
Fax 512-341-7370


Lakeline Location

12505 Hymeadow Drive
Suite 2C
Austin, TX 78750

Phone 512-238-0762
Fax 512-341-7370 


South Austin Location

4534 Westgate Blvd
Suite 108
Austin, TX 78745

Phone 512-238-0762
Fax 512-341-7370