Varicocele Microsurgery Treatment In Delhi, India
Dr Vijayant Govinda Gupta is the leading expert for Varicocele Microsurgery Treatment In Delhi, India. Varicocele is a condition characterized by the enlargement of veins within the scrotum, similar to varicose veins that occur in the legs. These veins, called the pampiniform plexus, are responsible for draining blood from the testicles. On this page know about Varicocele treatment in Delhi and Varicocele tratmenet cost in delhi.
Varicocele Microsurgery Treatment In New Delhi, India: Our Expertise In A Screenshot
- Expert in Varicocele Microsurgery: Dr. Gupta’s specialized training in microsurgery for effective treatment in New Delhi, India.
- Extensive Experience: Over 1000 successful varicocele microsurgery cases annually since 2016 in New Delhi.
- Cutting-Edge Microsurgical Techniques: Utilizes state-of-the-art equipment for precise varicocele treatment in New Delhi.
- Precision Instruments: German-made microsurgical tools ensure superior outcomes in New Delhi, India.
- Doppler Precision: Accurate identification and preservation of the testicular artery during varicocele microsurgery in New Delhi.
- Comprehensive Varicocele Treatment: Offering in-house solutions for varicocele management in New Delhi, India.
- Global Training Hub: Dr. Gupta trains surgeons worldwide in varicocele microsurgery in New Delhi, India.
- Affordable Microsurgery: Accessible and cost-effective varicocele treatment options in New Delhi, India.
What Is A Varicocele And Its Grades?
The spermatic veins carry blood from the testis back into the body. Normally they are small and of no consequence. But in some men, these veins dilate or swell up. There are many reasons for this. One could be kidney cancer or any swelling inside the abdomen. This needs to be ruled out. But mostly, varicocele happen due to still unknown reasons.
Some reasons why Varicoceles occurre are (Read more here)
- High estrogen levels
- Defective valves in Gonadal veins
- Lack of Retroperitoneal Fat
- Oblique insertion of gonadal veins into the Renal vein
- Chronic standing Jobs
- Inadequate support to testis
Whatever the cause, varicocele need to be identified early. There are several methods to grade a varicocele. But commonly they are graded clinically (in sitting and standing position) and on a Duplex Ultrasound.
Grades of Varicocele (Criteria Used By us for Diagnosis)
We have an in-house, high-quality ultrasonography suite, complemented by a trained radiologist who conducts scrotal Doppler ultrasounds with exceptional precision. This capability enables us to detect and treat varicoceles at an early stage, ensuring timely and effective care for our patients.
Grades | Vein Diameter (mm) | Blood Flow Direction |
0 | <2.5 mm | No Reflux |
1 | 2.5 – 4 mm | No Reflux |
2 | 4-5 mm | Minimal Reflux |
3 | >5 mm | Moderate Reflux |
4 | >5 mm | Severe Reflux |
Dr. Vijayant Govinda Gupta : Leading Varicocele Microsurgeon In India
Dr. Vijayant Govinda Gupta is the highest-volume varicocele surgeon in India, performing surgeries on over 300 patients annually. Additionally, he diagnoses and treats more than 6000 varicocele patients each year.
Credentials at a Glance
- Training: Dr. Gupta has received 14 years of rigorous training from India’s most prestigious institutions.
- Microsurgery: He is trained in microsurgery by the Government of India.
- Experience: Dr. Gupta has successfully treated over 1000 varicocele cases in just 3 years.
- State-of-the-Art Equipment: His operating room is equipped with the latest Karl Zeiss Microscope and imported German-made microsurgical instruments.
- Teaching: Dr. Gupta regularly imparts training to junior surgeons and doctors from both India and abroad.
- Continuous Learning: He actively participates in Continuing Medical Education (CME) programs to stay updated with the latest knowledge on varicocele and male infertility.
For more detailed information, you can read his full resume here or visit his LinkedIn profile.
Symptoms of Varicocele
These dilated spermatic veins or varicocele may or may not cause symptoms.
The most common symptoms of a varicocele are
- Pain – Pain is usually mild to moderate. It is more of a dragging sensation radiating along the testis. It may travel down the thighs or up the back.
- Reduction in Testis size
- Low Libido and low Testosterone levels
- Varicocele may cause Erectile Dysfunction(Varicocele and ED)
- Low sperm count or oligospermia
- Nil sperm count or Azoospermia
In some cases there may be no symptoms at all and varicocele is an incidental finding.
Does Varicocele Cause Male Infertility?
Varicocele is the number one treatable cause of male factor infertility. Varicocele precipitates male infertilty by the following methods
- Reduction in testis size
- Low sperm volume
- Low Sperm quantity
- Low Testesterone
- Low sperm motility
- May lead to complete loss of sperms in semen
- Loss of testis architecture
If you are suffering from male infertility then you need to rule out the presence of a varicocele. Varicocele treatment is absolutely essential to correct male factor infertility.
Indications for Varicocele Treatment In New Delhi India
Patients may seek varicocele treatment for various reasons, including:
- Persistent Testicular Pain: When experiencing discomfort or pain in the testicles that does not improve with conservative measures.
- Male Factor Infertility: Varicoceles are often associated with male infertility or the inability to conceive, making treatment a consideration for couples trying to have a child.
- Cosmetic Concerns: Some individuals opt for treatment due to cosmetic concerns, as varicoceles can sometimes cause visible swelling or enlargement of the scrotum.
- Career Aspirations: In cases where joining the army or government service is a career goal, individuals may choose treatment to meet medical requirements.
- Significant Testis Size Reduction: Treatment may be sought when there is a noticeable reduction in testis size, typically exceeding 20 percent.
- Low Testosterone Levels: Varicoceles can impact hormone balance, leading to low testosterone levels, which may prompt individuals to consider treatment.
- Azoospermia: Varicoceles can contribute to azoospermia, a condition characterized by the absence of sperm in the ejaculate, making treatment important for fertility.
- Erectile Dysfunction: While less common, varicoceles can potentially contribute to erectile dysfunction, which can motivate patients to seek treatment.
These are some of the key reasons why patients may choose to pursue varicocele treatment, with each case being unique and requiring individualized assessment and care.
What Are The Treatment Options for Varicocele?
The treatment options for varicocele include
- Surgical Treatment of Varicocele
- Subinguinal Microscopic Varicocele ligation (Goldstein Approach) – The best approach.
- Other old techniques like open and laparoscopic (Palamo)
- Nonsurgical Treatment of Varicocele
- Observation and watchful waiting (No treatment)
- Medicines for varicocele like Daflon, Vitamin E, L Carnitine etc
- Non surgical Varicocele Embolization
Varicocele Microsurgery Vs Percutaneous Embolization
Microsurgery for Varicocele is superior to Embolization. Microsurgery is more cost effective with higher success and lower recurrence rate.
| Parameter | Varicocele Microsurgery (Superior – Gold Standard) | Varicocele Embolization (Inferior – Alternative) |
|---|---|---|
| Cost | Cheaper | Expensive |
| Risk | No Risk to Kidney | Risk to Kidney |
| Contrast Nephropathy | No | Yes |
| Radiation Exposure | No | Yes |
| Blood loss | No | Yes |
| Infertility | Resolves Infertility | Damages Fertility |
| Effectiveness | 99% Effective | 80% Effective |
| Recovery | Fast | Slow |
| Incision | Small | Large |
| Hanging | Reduced | Increased |
References:
- Cassidy D, Jarvi K, Grober E, Lo K. Varicocele surgery or embolization: Which is better? Can Urol Assoc J. 2012 Aug;6(4):266-8. doi: 10.5489/cuaj.11064. PMID: 23093537; PMCID: PMC3433543. (Link)
- Halpern J, Mittal S, Pereira K, Bhatia S, Ramasamy R. Percutaneous embolization of varicocele: technique, indications, relative contraindications, and complications. Asian J Androl. 2016 Mar-Apr;18(2):234-8. doi: 10.4103/1008-682X.169985. PMID: 26658060; PMCID: PMC4770492. (Link)
- Kumar R, Gupta NP. Subinguinal microsurgical varicocelectomy: evaluation of the results. Urol Int. 2003;71(4):368-72. doi: 10.1159/000074087. PMID: 14646434. (Link)
- https://cuaj.ca/index.php/journal/article/view/1873
Complications of Percutaneous Varicocele Embolization
Embolization of varicocele is marketed as a non surgical treatment of Varicocele. It is a risky procedure with more than usual number of complications.
While percutaneous embolization is generally considered safe and effective for varicocele treatment, it’s essential to be aware of the following potential complications:
- Recurrence: Varicoceles may reoccur after embolization, necessitating additional treatment.
- Post-Embolization Pain: Some patients may experience post-procedure discomfort or pain, typically resolving with time.
- Bruising and Swelling: Common but usually temporary, bruising and swelling may occur at the catheter insertion site.
- Infection: Although infrequent, infection at the catheter insertion site can occur.
- Arterial Injury: In rare cases, there may be injury to the arterial system during the procedure, potentially leading to bleeding or other complications.
- Hydrocele Formation: Post-embolization, fluid accumulation around the testicle (hydrocele) may develop.
- Migration of Embolic Material: In some instances, embolic material may migrate to unintended areas.
- Allergic Reactions: While uncommon, patients may experience allergic reactions to materials used during embolization.
- Deep Venous Thrombosis (DVT): Although very rare, there is a small risk of developing deep venous thrombosis, a blood clot in the deep veins.
- Non-Treatment of Adjacent Varicoceles: In certain cases, embolization may not effectively treat adjacent varicoceles, requiring additional procedures.
The biggest risk is coil migration. The coil can enter the kidney, lungs or even block the blood supply of the intestines. Read here.
References :
2. Tiralongo F, Distefano G, Palermo M, Granata A, Giurazza F, Vacirca F, Palmucci S, Venturini M, Basile A. Liquid and Solid Embolic Agents in Gonadal Veins. Journal of Clinical Medicine. 2021; 10(8):1596. https://doi.org/10.3390/jcm10081596 (Download)
Advantages of Microsurgical Ligation Of Varicocele
All current evidence says that microscopic varicocele surgery is the best method to treat varicocele. It has the lowest recurrence rate and highest success rate. (Reference)
Varicocele surgery is a complex decision, but microscopic varicocele ligation offers several benefits, including:
- Lowest recurrence risk
- High success rates
- Preservation of the testicular artery
- Prevention of hydrocele by sparing lymphatics
- No risk of contrast or coil migration
- Simultaneous treatment for testis ptosis
- Minimal pain and discomfort
- Small incision
- Improved fertility outcomes in infertile men
- No exposure to ionizing radiation or X-rays
While 90% of men experience relief from pain and discomfort after varicocele surgery, about 10% may still have lingering discomfort. Nevertheless, surgery is recommended for this issue.
Varicocele microsurgery enhances sperm count and motility, enabling infertile couples to conceive naturally. Some studies suggest that it can also improve sperm parameters, potentially leading to better outcomes with in vitro fertilization and assisted reproduction.
It’s important to note that varicocele microsurgery does not guarantee eligibility for the Indian army. The Indian army typically requires a waiting period of 3 months post-surgery for individual case evaluation due to medico-legal considerations.
Varicocele Microsurgery In Delhi, India: What To Expect
Varicocele Microsurgery : Technical Information
Step | Description |
Duration of Surgery | 60 minutes |
Anesthesia | General or Regional |
Microscope used | Yes (Zeiss) |
Microinstruments | German |
Stitches | 1 to 2 Subcuticular (Absorbable) |
Varicocele Microsurgery : Recovery Information
Step | Description |
Travel | Immediately |
Bed Rest | No |
Heavy Work | Avoid for 90 days |
Intercourse / Sexual Activity | Avoid for 90 days |
Motorcycle | Avoid for 90 days |
Stitch Removal | After 7 days |
Join back Office | After 7 days |
Shower / Bath | Same Day |
Diet Precautions | As given for 60 days |
Follow up | After 30 days |
Pain | None |
Varicocele Microsurgery Cost In Delhi, India
Microscopic sub inguinal varicocele surgery packages per side is ₹40,000 – 50000.
- Daycare admission: ₹40,000 (for Indian nationals) or $1,000 (for Foreign nationals).
- Night Stay Private room: ₹75,000 (for Indian nationals) or $1,500 (for Foreign nationals).
- Investigations (additional, approximately): ₹2000 ($100)
The cost for Varicocele surgery in New Delhi India varies according to the method chosen, the hospital chosen, the anesthesia chosen and the surgical method. Varicocele treatment cost in Delhi India is more affordable than most places worldwide.
Please note the following legal disclaimers:
- The provided costs are approximate and subject to change. It is advisable to verify the most current pricing with the chosen healthcare provider.
- The prices mentioned may not encompass all potential expenses, such as pre-operative consultations, post-operative care, medications, and unforeseen medical complications.
- Prices may vary among different hospitals and medical facilities.
- Currency exchange rates can fluctuate, so consider checking the latest rates if you intend to pay in a currency other than the local one (INR).
- Medical tourism may involve additional expenses related to travel and accommodation; please factor these into your overall budget.
- All mentioned prices are in USD
Inclusions:
- Daycare Economy Ward admission:
- Surgical procedure.
- Ward admission in the economy ward.
- Basic medications during the hospital stay.
- Post-operative follow-up consultations.
- Daycare Private room:
- Surgical procedure.
- Ward admission in a private room.
- Basic medications during the hospital stay.
- Post-operative follow-up consultations.
Exclusions:
- Investigations (additional, approximately $100).
- Pre-operative consultations and diagnostic tests.
- Specialist consultations beyond the standard follow-up.
- Specialized medications or treatments required due to unforeseen complications.
- Travel and accommodation expenses.
- Any additional medical services or supplies not explicitly mentioned in the inclusions.
