✦ Varicocele Treatment

Open Inguinal Varicocelectomy (Ivanissevich)

Q: Why has the Ivanissevich technique been superseded?

Microsurgical varicocelectomy has lower recurrence (1% vs 5–15%) and fewer hydrocele complications; Ivanissevich remains valid where microscopy is unavailable.

Q: Is recovery similar to microsurgical varicocelectomy?

Recovery is very similar — most patients return to light work within 5–7 days and physical activity within 2–3 weeks.

Q: Will my fertility improve after Ivanissevich varicocelectomy?

Yes — improvement in semen parameters occurs in 60–70% of patients, with pregnancy rates improving comparably to other approaches.

Open Retroperitoneal Ligation of the Internal Spermatic Vein

45–60 min PROCEDURE

Day Care / 1 Day HOSPITAL STAY

>85% SUCCESS RATE

1–2 Weeks RECOVERY

What is Open Inguinal Varicocelectomy (Ivanissevich)?

The Ivanissevich procedure is the classic open varicocelectomy technique performed at the inguinal level through a muscle-splitting incision. The internal spermatic vessels are identified in the inguinal canal and all veins ligated, leaving the artery and vas deferens intact. While the microsurgical subinguinal approach has largely superseded it for fertility-related varicoceles, the Ivanissevich technique remains an effective and widely practised open approach. The procedure is performed under general or spinal anaesthesia with a hospital stay of Day Care / 1 Day. Success rates reach >85% in appropriately selected patients at experienced centres.

Men with symptomatic varicocele in settings where microsurgical or laparoscopic facilities are unavailable, or as an alternative open approach. Patients must be adequately fit for anaesthesia and free from active systemic infection before proceeding.

How the Procedure Works

Incision & Access

Inguinal incision made; external oblique aponeurosis opened.

Cord Delivery

Spermatic cord identified in the inguinal canal and delivered into the wound.

Vessel Separation

Internal spermatic veins separated from the artery and vas deferens by careful dissection.

Vein Ligation

All identified spermatic veins ligated with silk or absorbable sutures.

Wound Closure

External oblique repaired; wound closed in layers; scrotal support applied.

Outcomes

45–60 minDURATION

Day Care / 1 DayHOSPITAL STAY

>85%SUCCESS RATE

1–2 WeeksFULL RECOVERY

Who Needs This Treatment?

→Well-established technique with decades of outcome data.
→Effective treatment for symptomatic varicocele causing pain or infertility.
→No special equipment required beyond standard surgical instrumentation.
→Suitable in settings without microsurgical or laparoscopic facilities.
→Direct inguinal access to all spermatic vessels.
→Good post-operative improvement in semen parameters and pain symptoms.

"The Ivanissevich approach is a time-tested technique that has restored fertility for countless men. While the microscope offers advantages, skilled open surgery delivers excellent results when other options are unavailable."

— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon

Common Questions

Frequently Asked

Why has the Ivanissevich technique been superseded?+

Is recovery similar to microsurgical varicocelectomy?+

Will my fertility improve after Ivanissevich varicocelectomy?+

Not sure which treatment is right for you?

Book a consultation with Dr. Vipin Reddy and get a personalised treatment plan.

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