Urologist - Mark Brian Roa, MD, FPCS, FPUA

13/11/2025

Perfomed another case of microsurgical subinguinal varicocelectomy on a 33 year old patient with a palpable varicocele and abnormal semen parameters.

WHY CONSIDER A MICROSURGICAL SUBINGUINAL VARICOCELECTOMY

A better, safer, and more precise way to treat varicocele

A varicocele is an abnormal enlargement of the veins in the sc***um—like “varicose veins” in the legs, but in the testicles. It’s one of the most common and treatable causes of male infertility and testicular discomfort.

Why the Microsurgical Sub-Inguinal Approach Is an Advantage

This technique is considered the gold standard because it offers the best outcomes with the lowest risks. Here’s why:

✔️ Highest Precision

Using an operating microscope, the surgeon can clearly identify and protect important structures—like arteries, lymphatic vessels, and the vas deferens—while tying off the problematic veins.
Result: Better safety, lower complication rates.

✔️ Lowest Recurrence Rate

Because the microscope helps us see even the small abnormal veins, the chances of the varicocele coming back are significantly lower compared to older techniques.

✔️ Faster Recovery

The incision is small and placed below the groin (sub-inguinal), avoiding muscle layers.
Result: Less pain, minimal downtime, and faster return to daily activities.

✔️ Better Fertility Outcomes

Studies show improvements in s***m count, motility, and morphology. This procedure is commonly recommended for men trying to conceive.

✔️ Reduced Risk of Hydrocele

By carefully preserving lymphatic vessels, the microsurgical method dramatically reduces the chance of postoperative fluid build-up (hydrocele).

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When Should You Consider Varicocele Repair?

You may be advised to undergo microsurgical varicocelectomy if you have:

📌 Male infertility

Abnormal semen analysis with a clinically significant varicocele.

📌 Testicular pain

A persistent, dull, aching discomfort that affects daily life.

📌 Testicular asymmetry or shrinkage

One testicle becoming smaller due to long-standing varicocele.

📌 Abnormal testosterone levels

Some men experience low testosterone due to varicocele; repair may help improve hormone levels.

📌 Adolescents with testicular growth issues

In boys with a large varicocele causing stalled testicular growth.

13/10/2025

We came from different parts of the world, but in the operating room, we all speak the same language — precision, focus, and shared purpose.

31/08/2025

Medicine never stands still, and neither should we. Every patient deserves care that is backed by the latest knowledge and techniques.

It is our mission to continuously upgrade our skills so that we can offer the best options for men and couples facing fertility challenges.

This is about helping dreams of fatherhood come true.

31/08/2025

Celebrating my 9th year on Facebook. Thank you for your continuing support. I could never have made it without you. 🙏🤗🎉

23/06/2025

🔍 Ano ang Varicocele?

Ang varicocele ay ang paglobo o pamamaga ng ugat sa paligid ng bayag o itlog (testicles). Para itong varicose veins sa paa, pero sa sc***um. Dahil dito, nagkakaroon ng problema sa daloy ng dugo, at pwedeng tumaas ang temperatura sa bayag — na hindi maganda para sa paggawa ng malusog na semilya (s***m).

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❗Karaniwan ba ito? At paano nito naaapektuhan ang fertility ng lalaki?

Oo. Ang varicocele ang pinakakaraniwang nakikitang sanhi ng male infertility.
Maaaring bumaba ang dami, galaw, at kalidad ng s***m dahil sa:
• Mas mataas na init sa bayag
• Pagka-ipon ng toxins mula sa abnormal na daloy ng dugo
• Stress sa mga selula na gumagawa ng s***m

Hindi lahat ng may varicocele ay baog, pero kung may problema sa fertility, ito ang isa sa unang tinitingnan ng mga espesyalista.

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⚠️ Ano ang mga sintomas?

Marami sa mga lalaki ay walang nararamdaman. Pero sa iba, maaaring may:
• Pakiramdam ng bigat sa bayag
• Pananakit lalo na kapag nakatayo nang matagal
• Makikitang “guhit” o namamagang ugat sa sc***um
• Problema sa s***m count kapag nagpatingin

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🩺 Paano ito ginagamot?

Ang varicocelectomy ang pinakakaraniwang operasyon para dito.
Ito ay isang minor surgery kung saan tinatali o inaalis ang mga ugat na may problema sa pagdaloy ng dugo.
• Minimally invasive – Mabilis makarecover
• Ginagawa kung may infertility o pananakit
• Maaaring bumuti ang s***m count at quality pagkatapos ng operasyon

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📣 Final Message:

Kung ikaw ay may varicocele at may problema sa fertility, magpatingin sa isang urologist. Maaaring ito ang susi para mapabuti ang inyong tsansang magkaanak.

21/06/2025

Ang Dating Sigla, Ibalik ang Kumpiyansa.

As men age, it’s normal to experience changes—but that doesn’t mean we should simply accept fatigue, low drive, or declining performance as “part of getting older.”

This morning, I had the privilege to speak at Mary Mother of Church Parish, Las Piñas, to a group of men in their golden years about erectile dysfunction, testosterone deficiency, and sexual health—topics often ignored, but deeply impactful on confidence, relationships, and overall well-being.

Erectile dysfunction is more than a bedroom issue. It can be a sign of underlying health concerns—like diabetes, cardiovascular disease, or low testosterone—and it can quietly chip away at a man’s self-esteem.

That’s why we need to break the stigma, start the conversation, and educate more men about the changes they experience and the options available.

Because regaining strength, energy, and confidence isn’t just about medication—it’s about understanding your body, making better choices, and seeking help when needed.

Let’s keep talking about men’s health. Let’s keep showing up.

—
Mark Brian Roa, MD, FPCS, FPUA
Urologist | Men’s Health Advocate

17/06/2025

Advancing Male Fertility Surgery in the South: First Microsurgical Subinguinal Varicocelectomy in the South of the Metro Performed at Calamba Medical Center

We are proud to share that the first microsurgical subinguinal varicocelectomy has just been successfully performed at Calamba Medical Center, marking a significant step forward in male reproductive health services in the South of Metro Manila.

Varicocele, the abnormal dilation of the veins within the sc***um, is a leading and reversible cause of male infertility. Among the various surgical options available, microsurgical subinguinal varicocelectomy remains the gold standard due to its superior outcomes.

Why Microsurgical Subinguinal Varicocelectomy?
1. Highest Success Rates in Improving Fertility
• Studies consistently show improved semen parameters and pregnancy rates following this procedure, especially in men with clinically palpable varicoceles and abnormal semen analysis.
2. Minimally Invasive, Maximum Precision
• Performed under high magnification using an operating microscope, the procedure allows precise identification and ligation of dilated veins while preserving critical structures such as the testicular artery, lymphatics, and vas deferens.
3. Lower Complication and Recurrence Rates
• Compared to other techniques (open inguinal, laparoscopic, embolization), the microsurgical subinguinal approach has the lowest recurrence rates and a significantly reduced risk of hydrocele formation.
4. Faster Recovery
• Because the incision is made below the external inguinal ring, the muscle layers are not violated, resulting in less postoperative pain and faster return to normal activity.
5. Also Beneficial in Adolescents and Men with Scrotal Discomfort
• Beyond infertility, microsurgical varicocelectomy is also beneficial for adolescents with progressive testicular atrophy and men experiencing dull scrotal pain from varicoceles.

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This milestone reflects our continuing commitment to bringing advanced male fertility treatments closer to home. With growing awareness and accessibility, more men can now benefit from evidence-based andrology care without having to travel far.

06/06/2025

Invest in your health now…

05/06/2025

𝐌𝐞𝐞𝐭 𝐃𝐫. 𝐌𝐚𝐫𝐤 𝐁𝐫𝐲𝐚𝐧 𝐑𝐨𝐚, 𝐔𝐫𝐨𝐥𝐨𝐠𝐢𝐬𝐭

A dedicated specialist in urinary and male reproductive health—delivering expert and compassionate care for your urologic needs.

When to Schedule a Visit:

• Prostate health check-ups
• Urinary tract issues and infections
• Kidney stones and bladder concerns
• Male reproductive and fertility concerns
• Urologic consultations and treatment plans

Schedule an Appointment today:

• Tuesday & Thursday
• 10:00am - 1:00pm
• Saturday
• 1:00pm - 3:00pm
• Location: Room 503

📞 Call OPD to book your appointment at 0917-639-9225.
Prioritize your health today!

Discover more about our services at 🌐 calambadoctorshospital.com

03/06/2025

Be safe out there.

MANILA, Philippines — HIV cases in the country have surged by 500 percent, prompting the Department of Health (DOH) to call on the government to declare a national public health emergency. In a