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Prof. Dr. Teoman Cem Kadıoğlu

Istanbul University, Faculty of Medicine, Department of Urology

Robert College and Istanbul Faculty of Medicine. One year male infertility microsurgery is being trained at Monash University (Melbourne, Australia). The first microsurgical varicocele operation in Turkey was started in 1992 at Istanbul Medical Faculty (Çapa). It has been the only microsurgical varicocele surgeries for the last 25 years, and it has more than 5,500 varicocele microsurgery and the whole wide series with these features. He performs his surgeries at Acıbadem Fulya Hospital and Istanbul Surgery Hospital

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Important About Varicocele

Varicocele surgery is not a simple operation, it is likely to fail if it is not performed with microsurgical technique in experienced hands. After I started microsurgical varicocele surgery for the first time in Turkey in 1992, I found that the surgery was insufficient in many people who had previously undergone normal or microsurgical varicocele surgery, and I started to perform corrective microsurgery for them. For this reason, I have only been performing microsurgical varicocele surgery for the last 25 years, this number has exceeded 5500.

In more than 90% of my more than 5,500 patients who underwent microsurgical varicocele surgery, the values ​​in the sperm test increased, pregnancy was achieved in most of them, and the negative outcome in others.
Technical success is over 99% in more than 5,500 microsurgical varicocele operations that I have performed in the last 25 years; The rate of serious complications is 0%, the rate of minor complications such as simple wound infection is 1-2%.
In old techniques without microsurgery, varicocele persists after surgery in up to 40% of patients, the risk of hydrocele (swelling by accumulating fluid between the membranes of the testis) rises to 40%, and organ loss due to arterial damage is up to 5%. Of the more than 5,500 patients I have operated on for 25 years, the rate of serious complications has been 0%.

Varicocele is the enlargement and varicose veins of the testicular veins that can occur starting from adolescence. Varicocele occurs in 15% of all men and is the most common cause of male infertility.

Varicocele starts in adolescence, its negative effects gradually increase over the years and over time;

  • May cause infertility.
  • It can cause pain in the groin and leg.
  • It can cause a decrease in the male hormone testosterone.
  • It may cause the testicles to remain small in adolescence.
  • The diagnosis of varicocele should be made not by ultrasound, but by the examination of an experienced specialist. Varicocele that is not detected in hand examination should not be operated, it will not be beneficial. Varicocele is not an emergency, but surgery is required within 1-2 months.

    The most successful method in the treatment of varicocele and the least complication is microsurgical varicocele surgery, which will be performed by specially trained and experienced surgeons. Those who try to perform this surgery without microsurgery training fail, and it can lead to significant complications. The embolization method is unsuccessful in the treatment of varicocele and should not be applied due to high serious complication rates. It is not enough to use magnifying glasses for microsurgery, a high quality and powerful operating microscope should be used. If the surgeon's microsurgery experience is not sufficient, it may be useful to try to differentiate the artery using Doppler during surgery. Varicocele cannot be treated with drugs or herbs.

  • Varicocele surgery without microsurgery should not be preferred.
  • Microsurgical varicocele surgery is definitely not a simple operation; It is successful only in experienced hands who have received special microsurgery training.
  • Microsurgical varicocele surgery can lead to persistence of the varicocele, complications, and even organ loss in inexperienced hands. Correction of inadequate microsurgical surgery with re-microsurgical varicocele is difficult but possible. Considering the cost and difficulty of the microsurgical correction surgery, I suggest you come to me for the first surgery, not for correction.

    After a correct and complete microsurgical varicocele operation, varicocele does not recur. In cases where the surgery is performed inadequately, the term "recurrence" is used incorrectly because the varicocele does not disappear, and the varicocele continues because the surgery was not successful. Even if microsurgery has been performed for those who come saying that they have had varicocele surgery before, I find that the varicocele continues in more than half, and I perform correction microsurgery. Increase in sperm values and pregnancies are obtained in patients who have undergone correction microsurgery.

    If a man has varicocele, assisted reproductive methods such as in vitro fertilization, ICSI, vaccination should not be recommended! Varicocele disrupts the chromosomal structure of sperm (DNA fragmentation index, DFI)

  • Decreases the power to fertilize the egg.
  • It increases the probability of miscarriage even if fertilization occurs.
  • Pregnancy can be achieved after varicocele surgery for those who have tried in vitro fertilization many times and have not been successful. IVF should be considered as a last resort; The risk of congenital anomaly in the baby rises by 30%, early menopause and life risks may occur for the woman.

    Do not ask for opinions by sending a sperm analysis or ultrasound report; Since I only diagnosed varicocele as a result of my own hand examination, I do not make a decision based on your ultrasound result, I only evaluate the spermiogram examinations performed at the Istanbul Medical Faculty Andrology Laboratory, which I am the founder and trust of, or at the Biruni Laboratory Etiler branch (0212 358 5100) where the staff I trained works, I trust the examination you send and do not comment.

    .: About Hospital :.

    I perform microsurgical varicocele operations at Acibadem Fulya Hospital which is a world famous A+ quality health institute located at the centre of modern Istanbul.