Varicocele Surgery Recovery: Pain, Exercise, Work, Sex and Sperm Results After Surgery or Embolisation

Varicocele surgery recovery is usually quick and straightforward. Most men go home the same day, have a sore groin or scrotum for a few days, and are back at a desk within about a week. Recovery after embolisation, the non-surgical option, is often even shorter. This guide covers what to expect after either treatment: pain, swelling, getting back to work, exercise and sex, when to repeat a sperm test, and the problems to watch for. Advice differs between surgeons and centres, so always follow the instructions you are given.

Recovery at a glance

A typical pattern looks like this, although everyone heals at their own pace:

• Same day. Home within a few hours. Someone should take you home, and you should not drive for at least 24 hours after an anaesthetic or sedation.
• Days 1 to 3. Soreness, mild swelling and bruising. Rest, short walks and simple painkillers.
• Within a week. Most men are back to desk work and light daily activities, often sooner after embolisation.
• Weeks 2 to 6. A gradual return to sport, heavy lifting and physical work, depending on your team’s advice.
• About 3 months. A repeat semen test, if you were treated for fertility.

If you are still choosing between treatments, our guide to varicocele treatment options compares them.

Is varicocele surgery painful?

Surgery is done under a general or local anaesthetic, so you should not feel pain during the operation. Afterwards most men describe a moderate ache or soreness rather than severe pain. It is usually worst for the first two or three days and then eases steadily.

What you feel depends partly on the type of operation:

• Microsurgical surgery (through a small cut in or just below the groin crease) causes soreness around the cut and in the scrotum.
• Laparoscopic (keyhole) surgery leaves a few small cuts on the tummy. Some men also get shoulder-tip pain for a day or two from the gas used to inflate the tummy.
• Embolisation is done through a needle hole in a vein, usually in the groin, neck or arm. The scrotum may ache for up to about a week as the treated vein settles.

The first week after surgery

Practical steps that help in the first few days:

• Wear supportive underwear. Snug briefs or a scrotal support (an athletic support or jockstrap) reduce movement and ease the ache. Many men find it helps to wear it day and night at first.
• Use a cold pack. A cold pack or a bag of frozen peas wrapped in a cloth, held on the area for short spells, can reduce swelling. Never put ice directly on the skin.
• Take painkillers as advised. Simple painkillers are usually enough. Check with your team or pharmacist before taking anything new, especially if you take other medicines.
• Rest, but keep moving. Lie down with your feet up when you can, and take short walks around the house to keep your circulation going.
• Look after the wound. Keep the dressing clean and dry for as long as your team advises, often a day or two, then shower normally. Avoid baths and swimming until the wound has healed. Many surgeons use stitches that dissolve on their own.

Some bruising that spreads into the scrotum or along the shaft of the penis is common and fades over one to two weeks. Mild swelling can take a few weeks to settle completely.

Varicocele embolisation (embolization) recovery time

Recovery after embolisation is usually shorter than after surgery, because there is no cut in the groin or scrotum. Most men:

• Go home within a few hours of the procedure
• Return to normal daily activities within a day or two
• Avoid heavy lifting and hard effort for a few days, typically two to three
• Keep the puncture site dry for about 24 hours

Some centres ask you to avoid sex for up to two to three weeks. A mild ache in the scrotum, groin or back is common for a few days. The varicocele itself may take several months to shrink, so do not worry if the swelling is still there at your first check-up. For details of the procedure itself, see varicocele embolisation.

How long after varicocele surgery can you exercise?

There is no single timetable, and advice varies between surgeons. As a general guide:

• Walking can start on the first day and should build up gradually.
• Desk work is usually possible within a few days to a week after surgery, and often the next day or so after embolisation.
• Driving is usually fine once you are at least 24 hours past the anaesthetic and can move and brake comfortably. Check your insurer’s rules.
• Running, gym work, cycling and heavy lifting are often avoided for about two weeks after surgery. Some surgeons advise up to four to six weeks before heavy lifting or contact sports.
• Physical jobs may need two weeks or more off, depending on how heavy the work is.
• Sex can usually restart once the wound has healed and it is comfortable, often after about one to two weeks. Your team may give you a specific time.

Start back gently. If an activity brings on pain or swelling, ease off and try again a few days later.

When will sperm results improve?

If you were treated for fertility, it takes time to see any change. Sperm take roughly two and a half to three months to develop, so a test straight after treatment will not reflect the repair.

• A repeat semen test is usually done about three months after treatment. In one study of men followed after surgery, average sperm counts had improved by three months and did not improve further after six months.
• A second test at around six months is often arranged, especially if the first shows only partial improvement.
• Not every man improves, and better semen results do not guarantee a pregnancy. One review found natural pregnancy rates of roughly a quarter to four in ten couples in the shorter term after surgery, with wide variation between studies.

How long after varicocele surgery can my partner get pregnant? There is usually no reason to wait before trying, once sex is comfortable. If your partner is in her mid-thirties or older, or you have been trying for a long time, ask about not delaying other fertility treatment while you wait. Our guide to varicocele and fertility covers the evidence in more detail.

Varicocele after surgery: problems to watch for

Most men recover without problems. Possible complications include:

• Hydrocele. A build-up of fluid around the testicle, causing a soft, painless swelling. It is less common after microsurgical surgery and embolisation than after some other types of operation. Small ones often need no treatment. See how a hydrocele differs from a varicocele.
• Haematoma. A collection of blood under the skin, causing firm, tender swelling. Most settle on their own, but a rapidly growing one needs checking.
• Infection. The wound becomes red, hot, swollen or starts to ooze, sometimes with a fever.
• Recurrence or persistence. The varicocele returns or does not fully go away. Rates vary with the method, from about 1 to 2 in 100 after microsurgery to around 5 to 10 in 100 after embolisation and some other approaches.
• Ongoing pain. Most men treated for an aching varicocele improve, but some still have discomfort afterwards.
• Testicle shrinkage. Damage to the testicle’s artery is rare, and the risk is lowest with microsurgery.
• After embolisation only: inflammation of the treated vein, a reaction to the contrast dye, or, very rarely, a coil moving out of place.

Follow-up

Your team will usually see you a few weeks to a few months after treatment, sometimes with an ultrasound. This is a chance to check the wound, the swelling and any remaining symptoms, and to plan the repeat semen test. For background on the condition itself, see our varicocele guide.

When to see a doctor

Contact your treating team or a doctor if:

• The wound becomes red, hot, swollen or oozing
• You have a temperature above 38°C
• Pain is getting worse after the first few days, or painkillers are not helping
• Swelling in the scrotum is still growing after the first week, or a new soft swelling appears weeks later
• The varicocele seems to have come back

You can use our pelvic symptom check to note your symptoms before an appointment.

Get urgent medical help for sudden, severe pain in the testicle, a rapidly growing and very painful scrotal swelling, high fever with shivering, bleeding that does not stop with firm pressure, a painful swollen leg, or chest pain or sudden breathlessness. In Singapore, call 995 in an emergency.

This article is general information, not personal medical advice. Please speak to a doctor about your own symptoms. How we create our content.