Varicocele Embolization

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Many men live with pain in their testicles unaware, embarrassed or frustrated by their symptoms, not realising there is a relatively simple and minimally invasive treatment option that may be available to them. 

A varicocele is an enlarged vein or group of veins with abnormal blood flow in a man’s scrotum - rather like varicose veins found in the legs and can cause swelling, pain or infertility. 

Varicocele embolization is a safe, minimally invasive procedure which can successfully divert blood flow away from a varicocele, using a catheter to place tiny coils or a sclerosant (an injectable medicine that is injected into the veins causing them to close) into the faulty veins using image-guidance technology to block (embolize) the vein, relieving pain and swelling.  This can also improve sperm quality and therefore fertility.

What are the causes of a Varicocele

The scrotum is the sac that contains the testes, blood vessels and part of the spermatic cord.  Varicoceles are caused when the valves in the scrotal veins become dysfunctional or fail.  Blood flow from the testes and scrotum back to the heart pools in the veins causing the testicle to enlarge and form a varicocele.

Treatment options for varicoceles are available including minimally invasive procedures such as varicocele embolization or surgery.  Both choices have a similar success rate, but recovery time for embolization is often much shorter.  Treatment options should be discussed with your healthcare provider to weigh up which option best suits you. 

What are the signs and symptoms of varicoceles?

Often, varicoceles go undetected and it’s not until pain and swelling of the testes occurs, or investigations into infertility are explored that they’re diagnosed. 

Treatment

When performed by a vascular specialist, varicocele embolization is a highly successful alternative to surgery.  Performed under mild sedative and local anaesthetic, a small nick in the groin allows for a catheter to be instead into the femoral vein and through to the testicular vein under image-guidance.  

Small coils and/or sclerosant are placed into the vein with the assistance of a small amount of contrast dye to allow your Doctor to pinpoint the problematic veins and embolize the flow of blood into the affected vein. By blocking the ineffective vein, abnormal blood flow is stopped, and the blood flow is diverted to healthy veins and the varicocele is no longer able to thrive.

Once the procedure is complete, the catheter is removed, and pressure is applied to stop any bleeding.  A small closure device may be used to seal the small hole in the artery, in some cases and the tiny opening in the groin is covered with a small dressing.   

What are the benefits of Varicocele Embolization?

Varicocele embolization is a minimally invasive procedure that requires;

• NO general anaesthetic – only mild sedation and local anaesthetic
• Patients report little-to-no scarring
• Quick recovery time – patients can normally return to normal duties within days
• The procedure is done at your local hospital as a same day patient, allowing you to recover at home
• Success rates of 95% - similar to surgical techniques
• Low infection rates 

What happens after the procedure?

In most cases, you’ll be able to go home the same day and resume normal activities the next day.  Jogging or more strenuous activities may require a longer period before resuming.  Sexual activities may also need to be put on hold for a couple of weeks.

Follow up with your Doctor will be required and you will be given further instructions as to the time frame of your review, after your procedure.  If you develop any problems after the procedure such as warmth and redness at the injection site, you should report this to your Doctor prior to your follow up appointment.

It is estimated that in approximately 5-10% of patients who undergo varicocele embolization, that varicoceles return or the procedure doesn’t work.  Many factors affect this including age, any health problems that you may have and the anatomy of your varicocele. If you feel that you or your loved one may have a varicocele, make an appointment to speak to us today.