Operation Marmara with varicocele: reviews

Microsurgical operation Marmara is one of the types of surgical intervention for the treatment of a disease called varicocele. It is prescribed by a urologist when there is an expansion of the veins of the lumbar plexus of the testicle (varicocele), when the patient complains of discomfort in the scrotum, or when the size of the testicle decreases, its function decreases.

Advantages of Marmara surgery before other methods of combating varicocele

Operation Marmara every year more and more doctors is recognized as the most effective and reliable method of therapy for varicocele. The main advantages are:

- in the least number of relapses, which is possible due to microsurgical glasses and a microscope, which allow to process the smallest veins;

- in a small degree of traumatization of tissues;

- in a small and inconspicuous scar not larger than 2 cm;

- in almost complete absence of pain syndrome after surgery;

- in improving the quality and quantity of sperm;

- the ability to quickly return the patient to a normal lifestyle.

A few more differences between the operative methods according to Ivanissevich, or laporascopy, from the method of Marmar. Surgery for Ivanissevich suggests dissection of the aponeurosis, which can lead to traumatization of the muscles of the anterior abdominal wall, increasing the rehabilitation period and strengthening postoperative pain syndrome. Operation on Marmara allows you to cope with both left-sided and right-sided varicocele. And improvement of spermatogenesis and evaluation of fertility can be carried out after 6-9 months. Most men after the intervention on Marmara in the next few years have the opportunity to become fathers.

What are the indications for the appointment of the Marmara operation

The main and, in general, the only indication, when the Marmara surgery is prescribed, is considered varicocele - a disease that can occur without significant clinical manifestations, almost asymptomatic.

But often, when seeking help from specialists, patients complain of heaviness in the scrotal area, pain in the testicle. When the examination reveals abnormalities in the spermogram, which indicates a violation of the production of sperm with testicles. Non-surgical treatment of the disease is impossible, especially if it comes to complications that can lead to infertility. Operation Marmara with varicocele, according to world statistics, allows you to fully restore the childbearing function of the organ.

Varikotsele: what is it, what is fraught with

The disease involves the expansion of the veins of the testicles of the spermatic cord, which is associated with the disruption of the operation of check valves located in the veins. That is, a healthy valve ensures blood flow through the vein in only one direction, damages in the valves prevent them from holding back the outflow of blood. Any increase in pressure leads to the fact that the blood tends back.

Causes of the disease

Varicocele can be a manifestation of:

- congenital malformation of venous valves;

- congenital weakness of the vascular wall;

- increased pressure in the small pelvis or scrotum, which leads to bending, changing the shape and gradual squeezing of the veins.

To correct this pathology, there are many different methods, for example, surgery on Ivanissevich or laparoscopic method. Why became popular method Marmar? The operation practically excludes the possibility of damage to the muscles of the abdominal wall, damage to the arteries of the testicle, and inflammation.

Contraindications to the operation of Marmara

As with any surgical intervention, even the most effective and safe procedure can have contraindications:

- stage of exacerbation in chronic pathologies of internal organs;

- the first six months after a stroke, a heart attack or other ischemic heart diseases;

- inflammatory processes in the genitourinary system;

- influenza, ARVI and other infectious diseases.

How to Prepare for Intervention

Marmara's operation and preparation for it implies carrying out a standard scope of research: general, clinical and biochemical blood analysis, coagulogram, ECG, RW, syphilis, HIV, hepatitis, anesthesiologist examination on the eve of surgery.

Preoperative examination may be extended or, conversely, reduced depending on the scope of planned intervention, age and general condition of the patient.

Immediately before the operation follows:

- Shave off hair, if any, in the upcoming area of operation. This should be done carefully, without cuts on the skin and the appearance of further irritation.

- Some doctors practice the appointment of anti-inflammatory or antibiotic therapy, which reduces the risk of inflammation in the invasive area. Acceptance of drugs begins a few days before the operation.

- General anesthesia or spinal anesthesia assumes the last meal not later than 10 pm. The day before the operation is not allowed to eat, drink, smoke. In the evening on the eve of surgery and on the morning of the day of surgery, a cleansing enema is made.

- Local anesthesia does not require fasting or cleansing enema.

- Reception of anticoagulants should be stopped 5 days before the forthcoming operation. Instead, low - molecular - weight heparin preparations are prescribed , which reduces the risk of surgical or post-operative bleeding.

The operation of Marmara with varicocele, which testifies to the high effectiveness of the method, allows to restore the venous current and prevent the outflow of blood poisoning the testicles. Postoperative relapse occurs in only 5-7% of patients.

Types of anesthesia: what can be, what is more preferable

Marmara surgery can be performed under general anesthesia, which, like the rest, is performed by an anesthesiologist, while the patient falls asleep and wakes up after the operation is over.

Spinal anesthesia anesthetizes the entire lower half of the body. The injection is made in the area of the spinal column.

Local anesthesia will anesthetize only the invasive site, while the patient will be conscious, but the pain will not be felt. In recent years, more and more doctors prefer the local type of anesthesia.

How is surgery performed?

The operation begins with the surgeon dissecting the skin of the sub-brachial region, making a cut in the size of 1.5 - 2 cm. There is a seminal cord, which for convenience is excreted into the wound. With the help of a microscope, the surgeon secretes the testicular veins and binds them. Doctors prefer to use local anesthesia, as the patient can be asked to breathe and strain, which allows the doctor to better see everything, even the smallest, enlarged veins and venous branches. The microscope allows to make the process of dressing as correct as possible, without traumas of nearby nerves, lymphatic vessels and arteries. After suturing all the veins on the wound, the drainage is made by a rubber graduate. Then an aseptic bandage is applied to the incision site.

Surgical intervention lasts for 30-40 minutes. After that the patient is transported to the postoperative ward, where he remains for several hours under the supervision of a doctor. After two hours, having evaluated the patient's condition, the doctor can let him go home.

Postoperative period

The rehabilitation period after the operation of Marmara is minimal. It will only be necessary to come to the dressing several times, if there is no possibility to carry out the procedure at home. Already after a few days the patient can fully return to his usual lifestyle. However, it is recommended to refrain from sexual relations, from lifting and wearing weights and playing sports, so as not to break the integrity of the seams. This is confirmed by the patients' testimonials. Sutures are removed after 7-8 days. A small scar will be located below the line of wearing the laundry, in the area where the hair grows, so that it will remain invisible. Operation Marmara, reviews about which are exceptionally positive both from patients and from doctors, does not cause either testicular atrophy, dropsy, or any other complications that can be expected from other types of surgical intervention. This operation allows you to restore and prevent further expansion of veins, improve the quality of sperm.

According to many men, Marmara surgery is a quick and effective method of getting rid of varicocele, which allowed them to avoid postoperative complications, pain, discomfort and ugly scars.