Microsurgery in Andrology

• First and the most common use is in varicocele ligation. Varicoceles are dilated veins of the scrotum which are commonly found in general population. Primary indication for varicocele ligation include subfertility with clinically significant varicocele. Varicocele ligation is done by many different methods. Microscopic technique has shown far better result than any other technique. Microscopic varicocelectomy helps affected couples to achieve natural pregnancy.
• A second most common use is for sperm retrieval in cases of non-obstructive azoospermia (NOA). This is a procedure which help cases with nil sperm count to father their own child. In these cases testis are unable to produce sufficient amount of sperms to reproduce naturally. In this technique suitable part of tissue is searched in testis and removed for search of sperms. This procedure can’t be done with the naked eye so operating microscope is of utmost importance.
• Third important use is to reconstruct the duct. This technique is commonly used for vasectomy reversal and vasoepididymal anastomosis. Microscope is again of utmost importance for the success of the procedure because success depends on meticulous reconstruction with very fine sutures which are not visible with common loupe or naked eye.

Scrotal supporter or tight underwear is recommended for 2-3 weeks. He should contact immediately in case of abnormal swelling and fewer.