The Hidden Cost of Waiting: Why Los Angeles Men Shouldn’t Delay Varicocele Treatment
Posted on January 28, 2026 by root
If you’ve been diagnosed with a varicocele, there’s a good chance you’ve heard the phrase “let’s just keep an eye on it.” This watchful waiting approach might sound reasonable, but for men in Los Angeles and Beverly Hills who are hoping to start a family or simply want to protect their long-term reproductive and hormonal health, waiting can come with consequences that aren’t immediately obvious.
As a board-certified urologist and fellowship-trained male fertility specialist at Tower Urology and Cedars-Sinai, Dr. Justin Houman sees patients every week who wish they had sought treatment sooner. Understanding what’s actually happening inside your body when a varicocele goes untreated can help you make a more informed decision about your care.
What a Varicocele Actually Does to Your Body
A varicocele isn’t just an uncomfortable sensation or that often-described “bag of worms” feeling in the scrotum. It’s a vascular condition where blood pools in the veins surrounding the testicle, and that pooling creates a chain reaction of problems that worsen over time.
The testicles hang outside the body for a reason. Sperm production requires temperatures roughly two degrees Celsius cooler than core body temperature. When blood pools in varicocele-affected veins, it raises scrotal temperature and creates an environment that’s hostile to healthy sperm development.
For men across the greater Los Angeles area who are actively trying to conceive or planning to in the future, this temperature increase can have significant consequences:
- Sperm DNA Fragmentation: elevated heat generates oxidative stress, which damages the genetic material inside sperm cells and reduces the likelihood of successful conception
- Declining Sperm Parameters: count, motility, and morphology often deteriorate progressively the longer a varicocele remains untreated
- Testicular Atrophy: prolonged pressure and elevated temperatures can cause the affected testicle to shrink, permanently reducing its capacity to produce both sperm and testosterone
Many couples spend thousands of dollars on female-focused fertility treatments like IVF or IUI, only to discover that an untreated varicocele in the male partner was undermining their chances all along. Dr. Houman’s fellowship training in Male Reproductive Medicine and Surgery at UCLA Medical Center gives him unique insight into how varicoceles fit into the broader fertility picture for couples throughout Beverly Hills, Santa Monica, and the San Fernando Valley.
The Testosterone Connection Most Men Don’t Know About
While many men initially seek varicocele evaluation because of fertility concerns, an increasing number of patients at Dr. Houman’s Los Angeles practice are discovering that varicoceles play a hidden role in low testosterone symptoms.
The Leydig cells responsible for producing testosterone are located in the testicles, and they’re sensitive to the same temperature and pressure changes that affect sperm production. When blood pools in a varicocele, it impairs Leydig cell function, which can lead to lower testosterone levels over time.
Symptoms of low testosterone include fatigue, decreased libido, difficulty building muscle, mood changes, and brain fog. Many men in the Encino, Pasadena, and Calabasas areas assume these symptoms are just part of aging, when the underlying cause might actually be treatable.
Research has shown that varicocele repair can lead to natural increases in serum testosterone levels. For men who want to avoid lifelong testosterone replacement therapy, addressing a varicocele early may help preserve their body’s ability to produce hormones naturally. This is particularly relevant for younger men who hope to maintain their fertility options.
Why Surgical Technique Matters for Los Angeles Patients
Not all varicocele repairs are created equal. While some providers offer embolization or traditional open surgery, men focused on fertility restoration and minimal complications should understand why microsurgical varicocelectomy has become the gold standard.
Dr. Houman performs subinguinal microsurgical varicocelectomy using high-powered surgical microscopes that allow him to identify every tiny vein contributing to the varicocele while carefully preserving the delicate arteries and lymphatic vessels that are critical for testicular function.
This precision matters for several reasons:
- Lowest Recurrence Rates: microsurgical technique achieves recurrence rates below one percent, compared to ten to fifteen percent with other approaches
- Minimal Complication Risk: by preserving lymphatic vessels, microsurgery dramatically reduces the risk of post-operative hydrocele (fluid accumulation around the testicle)
- Best Fertility Outcomes: preserving arterial blood supply ensures the testicle maintains optimal function after surgery
- Faster Recovery: most patients return to light office work within 48 to 72 hours
As a second-generation urologist who completed his fellowship at one of the nation’s most specialized male reproductive surgery programs, Dr. Houman brings technical expertise that directly impacts surgical outcomes for men throughout Los Angeles County.
Comparing Your Treatment Options
When evaluating varicocele treatment, Los Angeles patients have several choices. Understanding the differences can help you make the best decision for your situation:
Embolization involves threading a catheter through veins to block blood flow. While minimally invasive, it carries moderate success rates (85 to 90 percent) and may have higher recurrence rates than surgical options.
Laparoscopic Surgery uses small abdominal incisions and cameras. Recovery typically takes one to two weeks, but the technique makes it difficult to preserve lymphatic vessels, increasing hydrocele risk.
Microsurgical Varicocelectomy offers the highest success rates (over 99 percent), the lowest recurrence and complication rates, and recovery times of just two to three days. This is the approach Dr. Houman uses for his Beverly Hills and greater Los Angeles patients.
What to Expect From Recovery and Results
One of the most common questions men have is when they’ll see improvement after varicocele repair. Because it takes approximately 90 days for a complete new cycle of sperm to be produced, Dr. Houman typically schedules follow-up semen analysis three to four months after surgery.
Most patients can return to desk work within a few days. Heavy lifting and high-intensity workouts should be avoided for about two weeks to ensure optimal healing. Many men report noticing improvements in testicular comfort and energy levels within the first few weeks, though the full fertility and hormonal benefits develop over the following months.
Common Questions About Varicocele Treatment
Will my insurance cover microsurgical varicocelectomy?
Most insurance plans cover varicocele repair when documented fertility issues or testicular pain are present. Dr. Houman’s team can help verify your specific coverage.
Can a varicocele come back after surgery?
With microsurgical technique, recurrence rates are below one percent, making it extremely unlikely when performed by an experienced specialist.
I’m not trying to have kids right now. Should I still consider treatment?
Yes, particularly if you want to preserve your fertility options. Progressive testicular damage is difficult to reverse once it occurs, and addressing a varicocele now can protect your future reproductive potential.
Take Control of Your Reproductive Future in Los Angeles
Fertility is a journey where time truly matters. Every month that passes with an untreated varicocele is a month of potential progressive damage to sperm quality, testicular size, and testosterone production. By addressing the issue proactively, you’re not just treating a vein problem—you’re protecting your long-term hormonal health and keeping your family-building options open.
Dr. Justin Houman, MD, FACS, brings fellowship-trained expertise in male reproductive microsurgery to patients throughout Los Angeles, Beverly Hills, West Hollywood, Santa Monica, and the San Fernando Valley. To schedule a consultation and learn whether varicocele treatment is right for you, contact the office at (310) 854-9898 or request an appointment online. Your reproductive future is worth more than watchful waiting.