Urology

1. Microsurgical Varicocele Correction

What is a Varicocele?

A varicocele is an abnormal varicose enlargement of the veins within the scrotum. It is a common condition, diagnosed in 10–15% of men. A varicocele elevates the temperature in the testicles, thereby disrupting sperm development and potentially leading to male infertility (it is found in approximately 40% of men experiencing infertility). In its more severe stages, it can lead to testicular atrophy. Pain due to a varicocele is relatively rare.

Symptoms of a Varicocele

• A palpable "bundle" of veins in the scrotum above the testicle.
• Occasionally – a feeling of heaviness in the testicle, which intensifies with physical exertion and during intercourse.
• In severe stages – a reduction in testicle size (atrophy).
• Rarely – pain or discomfort in the testicle and groin area during physical exertion or coughing.

If you experience any of these symptoms, it is recommended to consult an andrologist or urologist.

At the iVF Riga Andrology and Urology Centre, we utilize a modern microsurgical method for varicocele correction, performed under a specialized surgical microscope.

The microsurgical approach to treating varicoceles and infertility represents a high-precision standard in modern urology and andrology. Contemporary varicocele correction is no longer unimaginable without this technique. By using a specialized operating microscope, surgeons achieve exceptional tissue visualization that is unattainable with traditional methods. This guarantees maximum gentleness, safety, and high efficacy.

Why is Microsurgery the Gold Standard?

This advanced approach offers fundamental advantages for both the physician and the patient:

Maximum Precision: Microscope control allows the specialist to selectively identify and ligate only the pathological veins, completely preserving the arteries and lymphatic vessels.

Minimized Risks: Compared to classic open surgeries, the risk of postoperative hydrocele formation and bleeding is significantly reduced.

Faster Rehabilitation: Thanks to the gentle and minimally invasive nature of the procedure, the patient can return to their normal daily routine within 2–3 weeks.

Clinical Data Shows: The microsurgical method increases the probability of a successful outcome up to 70%, whereas the efficacy of traditional methods varies only between 30% and 35%.

A Solution for Severe Male Infertility (Azoospermia)

The microsurgical method is critical not only for varicocele treatment but also in cases where no sperm are found in the ejaculate (azoospermia).

Using a high-end microscope, it is possible to perform targeted sperm retrieval directly from the testicular tissue (MicroTESE). This procedure provides high-quality material for subsequent medically assisted reproduction (IVF), offering hope of becoming parents even in the most complex cases of male infertility.

2. Circumcision or surgical removal of the foreskin

iVF Riga offers to perform a circumcision or removal of the foreskin at our clinic.

What is a circumcision?

Circumcision is a surgical removal of the foreskin. It can be performed for medical, or ritual purposes.

The procedure helps in getting rid of unpleasant feelings like foreskin narrowing that prevents sliding the foreskin over the glans; it is recommended if chronic inflammations occur in the foreskin and the area of the glans, if there are foreskin neoplasms, or for cosmetic purposes.

How does the surgery take place?

The surgical intervention lasts from 30 to 60 minutes, and is performed in the local, general or spinal anaesthesia.

During the operation, a cut is performed in the foreskin around the glans, then it is closed with sutures, and the patient may return home on the same day.

Post-operative period

Discomfort in the penis may continue for 2 to 7 days. If doctor’s recommendations are followed, the risk of complications is minimal.

On the day after the procedure, the patient should arrive for a scheduled check that includes changing the dressing. During the post-operative period, the patient should avoid physical and sexual activity for 14 to 20 days.

Circumcision can be performed at iVF Riga Andrology and Urology Centre. For appointments: (+371) 67 111 117; (+371) 25 641 022; ivfriga@ivfriga.eu

3. Hydrocele excision and plastic surgery

iVF Riga offers hydrocele excision and plastic surgery.

What is hydrocele?

Hydrocele is accumulation of fluids (usually dozens of millilitres) between testicular membranes due to reflux disorders in lymphatic vessels. Hydrocele may be hereditary, as well as acquired. Usually, the accumulation is slow and does not present any symptoms except a visual defect. If the hydrocele is more severe, a surgery is indicated.

How does the surgery take place?

The surgical intervention lasts from 30 to 60 minutes, and is performed in the general or spinal anaesthesia.

During the operation, a cut of 7 to 10 cm is performed in the scrotal sac to remove the hydrocele, and then it is closed with sutures, and the patient may return home on the same day.

Post-operative period

Discomfort in the scrotal sac may persist for 2 to 4 days. If doctor’s recommendations are followed, the risk of complications is minimal.

On the day after the surgery, the patient should arrive for a scheduled check that includes changing the dressing. During the post-operative period, the patient should avoid physical and sexual activity for 7 to 10 days.

Hydrocele excision and plastic surgery can be performed at iVF Riga Andrology and Urology Centre. For appointments: (+371) 67 111 117; (+371) 25 641 022; ivfriga@ivfriga.eu

4. Spermatocele excision

What is spermatocele?

Spermatocele is one or several cysts that develop in the epididymis. Spermatozoids that have completed their maturation cycle in the testis end up in the epididymis where their final maturation takes place during movement from the head of the epididymis to its body and later to its tail (where they accumulate waiting for ejaculation).

Small spermatocele cysts are often found in men (in approximately 30% of all men); usually they are small and filled with the lymphatic fluid, and do not cause any problems. They may be hereditary or acquired during one’s life (as a result of testicular trauma). They rarely cause any pain, but men often find a smaller or larger “lump” above the testis.

Occasionally, these cysts may be very large or purulent, and interfere with normal functioning of the epididymis during the spermatozoid development process. If you have found such “lump” just above the testis, please see an andrologist at the iVF Riga Andrology and Urology Centre who will perform an ultrasound examination of your scrotal sac to decide if the cyst should be removed surgically via the spermatocele excision.

How does the surgery take place?

The surgical intervention lasts from 30 to 60 minutes, and is performed in the general or spinal anaesthesia.

On the day after the procedure, the patient should arrive for a scheduled check that includes changing the dressing. During the post-operative period, the patient should avoid physical and sexual activity for 7 to 10 days.