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MALE INFERTILITY · TESTICULAR PAIN
Microscopic Varicocelectomy in Istanbul
Assoc. Prof. Tuncay Taş ties off the swollen veins above the testis under an operating microscope. At the same time, he keeps the artery, the lymph vessels and the sperm duct intact, so the repair lasts and the testis stays healthy.
1-2 hours
for one or both sides
Same day
you go home
2-3 cm
cut below the groin
3-4 days
stay in Istanbul
Career figures from Assoc. Prof. Taş's clinical profile. Your written quote follows the consultation and your test results.
Medically reviewed by Assoc. Prof. Dr. Tuncay Taş, urologist · Updated October 2026
What is a microscopic varicocelectomy?
A varicocele is a group of swollen veins above the testis, much like varicose veins in the leg. It affects about 15 in 100 men and up to 40 in 100 men with fertility problems. In addition, most sit on the left side.
A microscopic varicocelectomy closes these veins through a small cut just below the groin. Under magnification, the surgeon sees each tiny vessel clearly. So he ties only the faulty veins and spares everything the testis needs.
The blood then returns through healthy deeper veins. As a result, the testis cools down and works in a calmer environment. Sperm quality often improves over the following months, and the dull ache usually fades.
Which situation brings you here?
Most men reach this page after a semen test, a scan or months of a heavy feeling in the scrotum. So pick the line closest to yours and jump to the answer.
How is a varicocele graded?
Urologists grade a varicocele by how easily they can feel or see it. Grade matters, because larger varicoceles respond better to repair. Small ones found only on ultrasound, however, rarely need surgery.
Subclinical
What the doctor finds: Seen only on Doppler ultrasound
Usual approach: No surgery; follow-up if needed
Grade 1
What the doctor finds: Felt only when you strain or bear down
Usual approach: Repair if semen is abnormal or pain persists
Grade 2
What the doctor finds: Felt easily while standing, without straining
Usual approach: Repair if semen is abnormal, pain persists or the testis shrinks
Grade 3
What the doctor finds: Visible through the skin, like a bag of worms
Usual approach: Repair is usually advised
Tests before any decision
Assoc. Prof. Taş examines you standing and lying down, and he orders a scrotal Doppler ultrasound. In addition, he asks for two semen analyses and, in many men, a testosterone test. Together, these results show whether repair is likely to help.
Who needs varicocele surgery?
Not every varicocele needs an operation. In fact, many men with a varicocele father children naturally. Assoc. Prof. Taş therefore recommends repair in these situations:
A palpable varicocele, abnormal semen results and a couple trying to conceive
A dull ache or heaviness that persists despite simple measures
A testis that is clearly smaller than the other, especially in young men
Azoospermia with a palpable varicocele, before micro-TESE sperm retrieval
Low testosterone with a large varicocele, in selected men
What the guidelines say
Guidance differs between countries, and you deserve to know this. In the UK, NICE advises against varicocele surgery as a fertility treatment, because trials did not show higher pregnancy rates. American and European urology guidelines, by contrast, support repair for a palpable varicocele with abnormal semen results.
So the decision depends on your semen, your partner's age and your shared plans. For example, if your partner is over 35, IVF may come first, since repair needs months to show its effect.
Varicocele and pain
The ache typically grows during the day and eases when you lie down. Supportive underwear and rest help some men. When pain persists, however, surgery relieves it in most men.
Microsurgery, laparoscopy or embolisation?
Several methods close the faulty veins, but they differ in recurrence, side effects and recovery. Here is how the four main options compare.
Access
Microsurgical subinguinal: 2 to 3 cm cut below the groin
Laparoscopic: Three small ports in the abdomen
Open inguinal or high ligation: Larger cut in the groin or flank
Embolisation: Catheter through a vein in the neck or groin
Recurrence
Microsurgical subinguinal: Lowest, about 1 to 2 per cent
Laparoscopic: Higher
Open inguinal or high ligation: Highest
Embolisation: Higher, and some veins cannot be reached
Hydrocele after surgery
Microsurgical subinguinal: Below 1 per cent
Laparoscopic: More common
Open inguinal or high ligation: Most common
Embolisation: Rare
Anaesthesia
Microsurgical subinguinal: General or spinal
Laparoscopic: General
Open inguinal or high ligation: General or spinal
Embolisation: Local with sedation
Radiation
Microsurgical subinguinal: None
Laparoscopic: None
Open inguinal or high ligation: None
Embolisation: X-ray guidance
Why the microscope makes the difference
Below the groin, many small veins surround the artery and the lymph vessels. Without magnification, a surgeon can miss a vein or tie a lymph vessel by mistake. Then the varicocele returns, or fluid collects around the testis as a hydrocele.
With the microscope and a tiny Doppler probe, Assoc. Prof. Taş finds the artery, spares the lymph vessels and ties every faulty vein. That is why microsurgery has the lowest recurrence rate of all methods.
Your days in Istanbul, step by step
Most men stay in Istanbul for three to four days. Both sides can be repaired in the same session if needed.
01
Consultation and scan
First, Assoc. Prof. Taş examines you and reviews your semen and hormone results in person. Then you have a scrotal Doppler ultrasound if you lack a recent one. Finally, he confirms which side needs repair.
02
Preparation
First, you stop blood thinners about a week before, under your doctor's guidance. Then, on the day of surgery, you fast for six hours.
03
The microsurgery
Under general or spinal anaesthesia, he makes a 2 to 3 cm cut just below the groin. Then he lifts the spermatic cord, ties each faulty vein under the microscope and closes the skin with dissolving stitches. One side takes about an hour.
04
Home the same day
You rest for a few hours and go home with scrotal support. A check-up follows before you fly. Most men fly home two to three days after surgery.
What results can you expect?
Sperm take about three months to form, so changes appear slowly. Therefore Assoc. Prof. Taş repeats the semen analysis at three and six months after surgery.
Better sperm count and movement
What usually happens: Improvement in about 6 to 7 of every 10 men
When you notice it: 3 to 6 months
Pain relief
What usually happens: Most men feel clear relief
When you notice it: Within weeks
Sperm in men with azoospermia
What usually happens: Sperm return to the semen in a minority
When you notice it: 3 to 6 months
Testosterone
What usually happens: Often rises in men with low levels
When you notice it: 3 to 6 months
Natural pregnancy or IVF afterwards?
Better semen can make natural conception possible, or it can move a couple from IVF to simpler treatment. However, repair cannot promise a pregnancy. So you should plan the timeline with your partner's fertility doctor too.
Recovery after varicocele surgery
Recovery is quick, because the cut is small and no muscle is divided. Still, a few simple rules help the area heal well.
Return to desk work after two to three days.
Wear scrotal support for about two weeks.
Avoid heavy lifting, running and the gym for two to three weeks.
Wait about two weeks before sex.
Repeat the semen analysis three and six months later.
What are the risks of microscopic varicocelectomy?
Microsurgical repair is a safe, short operation, and serious problems are rare. Still, honest information helps you plan, so here are the effects every man should know.
Swelling and bruising: common, and it settles within one to two weeks.
Hydrocele: fluid around the testis, below 1 per cent with microsurgery.
Recurrence: about 1 to 2 per cent, the lowest of all methods.
Wound infection: rare; call if redness spreads or a fever starts.
Damage to the testicular artery: very rare, since the Doppler probe helps protect it.
How much does varicocele surgery cost in Istanbul?
Microscopic varicocelectomy in Istanbul with Assoc. Prof. Taş is priced individually after your consultation and scan. By comparison, self-pay prices in the United States usually run from about $5,000 to $10,000. Private hospitals in the United Kingdom, meanwhile, charge about £3,000 to £5,000.
Microsurgical varicocelectomy, one side
Istanbul, Assoc. Prof. Taş: Written quote after consultation
United States (self-pay): $5,000 to $9,000
United Kingdom (private): £3,000 to £4,500
Microsurgical varicocelectomy, both sides
Istanbul, Assoc. Prof. Taş: Written quote after consultation
United States (self-pay): $6,000 to $10,000
United Kingdom (private): £3,500 to £5,000
Your written quote lists the operation, the surgeon fee, anaesthesia and aftercare. In addition, the team arranges your hotel and transfers.
Why the price is lower in Istanbul
The gap comes from running costs, not from cheaper care. For example, salaries, hospital overheads and insurance premiums cost far less in Turkey. So the same microscope and the same standard cost a fraction of a US bill.
Travelling from the US, Canada or the UK
Many men come because of a long wait at home or because insurers decline fertility surgery. Either way, a little planning makes the trip simple.
Before you fly
Bring your recent semen analyses and any hormone results.
Bring your scrotal ultrasound report, if you have one.
Bring a list of your medicines, especially blood thinners.
Back home
Finally, you leave with the operation note in English. So your family doctor or local urologist can arrange the semen tests at three and six months.
Why patients choose Assoc. Prof. Tuncay Taş
Assoc. Prof. Dr. Tuncay Taş is a urologist with more than 20 years of experience. He also founded Safe Urology Clinic in Istanbul, and patients travel to him from over 60 countries.
Medical degree from Istanbul University School of Medicine, 2004
Urology residency at the University of Health Sciences, Taksim Training and Research Hospital
Fellowship in urological oncology and laparoscopic urology, Heidelberg University, Germany
Surgery in JCI-accredited partner hospitals in Istanbul
Member of the European Association of Urology and the Endourological Society
He also publishes research on testicular biology and the groin region. Read his full background on the About Us page, or see his wider work in men's health and andrology.
Frequently asked questions
Is varicocele surgery painful?
You sleep or stay numb during the operation. Afterwards, mild soreness lasts a few days, and simple painkillers usually control it.
How successful is microscopic varicocelectomy?
Semen improves in about six to seven of every ten men, and most men with pain feel relief. Recurrence is only about 1 to 2 per cent.
How much does varicocele surgery cost in Turkey?
Assoc. Prof. Taş gives a written quote after your consultation and scan. It lists surgery, anaesthesia and aftercare.
How long does recovery take after varicocelectomy?
Most men return to desk work in two to three days. Sport and heavy lifting wait two to three weeks.
Can a varicocele go away on its own?
No. The faulty valves do not repair themselves, although many small varicoceles never cause problems.
Can a varicocele cause infertility?
It can lower sperm count and movement by warming the testis. Still, many men with a varicocele father children naturally.
When will my sperm count improve?
Sperm take about three months to form. So the first useful semen test comes three months after surgery, and the next at six months.
Is microsurgery better than embolisation?
Microsurgery has the lowest recurrence rate and no radiation. Embolisation avoids a cut, but it fails more often and some veins cannot be reached.
Can both sides be treated at once?
Yes. When both sides need repair, Assoc. Prof. Taş treats them in the same session.
When can I fly home after varicocele surgery?
Most men fly two to three days after surgery. Walk during the flight and avoid lifting heavy bags.
Assoc. Prof. Taş's published research
These peer-reviewed papers come from Assoc. Prof. Taş's own work on testicular biology and the groin region.
The histology and the proapoptotic control in the ipsilateral and the contralateral testes following unilateral vasectomy. Archivio Italiano di Urologia e Andrologia, 2015. Co-author.
Relationship between lower urinary tract symptoms and inguinal hernia. Archivio Italiano di Urologia e Andrologia, 2016. Co-author.
Public health information
This page informs and does not replace an in-person medical consultation. So treatment decisions always follow your own examination, scans and semen results.
Talk to Assoc. Prof. Taş about your varicocele
Book a consultation and get a clear plan, a written quote and dates that suit your trip.
