Complications

Complication
Timeframe
Likelihood
short term
low

Can occur following percutaneous embolisation, but relatively uncommon.

variable
low

Can occur as a result of untreated varicocele or post-surgical complication. Damage to the testicular artery intraoperatively may result in testicular atrophy. Can occur with any surgical approach.

variable
low

Few varicoceles (<20%) cause infertility; however, the prevalence of varicocele is greater in patients with subfertility.[7][8]​ Varicoceles are identified in up to 40% of male infertility patients.[9]​ Untreated varicocele may lead to progressive decline in semen parameters.[10]

variable
low

Untreated varicoceles may cause Leydig cell dysfunction and subsequent hypogonadism.[1][31]​​

variable
low

Unclear aetiology; thought to be secondary to lymphatic obstruction.

Incidence of hydrocele varies with procedure: microscopic inguinal or subinguinal surgery (0.4%); laparoscopic surgery (2.8%); inguinal surgery (7.3%); open retroperitoneal high ligation (8.2%).[51][73]

In children and adolescents, incidence of postoperative hydrocele varied between 0.8% and 11.4%, with higher rates reported with laparoscopic mass-ligation/division and lower rates for laparoscopic lymph-sparing surgery and embolisation and sclerotherapy techniques.[52]

Most can be safely observed and regress without treatment; some will respond to simple puncture, although if further recurrence is symptomatic, open repair may be indicated.[74]

Usually, hydrocele forms anywhere from 6 months to 3 years post-procedure.[75] Long-term follow-up is needed to document true incidence.

variable
low

Usually occurs as a result of missing veins during primary surgery; recurrence is higher if an artery-sparing technique is used.​[76][77]

Incidence of recurrence varies with procedure: ​microscopic inguinal or subinguinal surgery (1.1%); laparoscopic surgery (4.3%); inguinal surgery (2.6%); open retroperitoneal high ligation (15.0%); embolisation (12.7%).[51][73]

Can take up to 6 months to see resolution of varicocele depending on technique chosen.

variable
low

A possibility with transperitoneal laparoscopic approach, or with other approaches in the presence of an unexpected hernia.

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