Varicocele embolization is a minimally invasive treatment for varicocele, an abnormal enlargement of the veins in a man’s scrotum that can cause mild to severe pain and lead to infertility.
At Vascular and Interventional Partners in Phoenix, AZ, our team of experienced interventional radiologists regularly performs varicocele embolization. As a minimally invasive, outpatient treatment option, the procedure involves fewer risks and less recovery time than more invasive surgery. It can help relieve pain and discomfort by blocking blood flow to the affected veins and boost fertility down the line.
What Is a Varicocele?
Varicocele is simply varicose veins in the scrotum. More specifically, it is a condition where the pampiniform plexus (a network of veins within the spermatic cord) becomes enlarged, swollen and sometimes painful. Varicocele is the top cause of male infertility and affects 15 to 20 percent of all men. Besides causing infertility, varicocele can compromise normal testicular functioning and lead to reduced testosterone production.
Most men with varicocele do not have noticeable symptoms and thus do not require treatment. Those that do develop problems will usually have the following:
- Dull testicular pain and aching
- Worsening pain after standing
- Swollen testicles or scrotum
- A lump above the affected testicle
- A “bag of worms” feeling in the scrotum
In approximately 90 percent of all cases, the left testicle is affected.
The primary reason varicocele can become uncomfortable is because of faulty valves. These are observed in all varicose veins, causing blood to flow backward and pool inside the veins, causing painful swelling. Why this condition is often linked to male fertility is less understood, however. One theory suggests that varicocele raises testicular temperature, which interferes with normal sperm production.
Fortunately, men have several treatment options to choose from to relieve the symptoms of varicocele or to increase their chances of natural conception.
Varicocele treatment options include surgery and embolization. Surgical options include open and laparoscopic surgery to repair the faulty blood vessel. These approaches require general anesthesia. Embolization does not require general anesthesia and can be done on an outpatient basis.
What Is Varicocele Embolization?
Varicocele embolization is a nonsurgical interventional radiology procedure performed for the treatment of varicocele. Like all embolization procedures, it works by blocking blood flow to the affected area.
During a varicocele embolization procedure, an interventional radiologist makes a small puncture, usually near the upper thigh area, and inserts a catheter into one of your main arteries. Using x-ray image guidance, they then direct the catheter toward the treatment area and release particles or coils (embolic agents) to block the defective vessels. In the case of varicocele embolization, doctors usually use coils made from platinum or other metals to block the varicose veins.
Once the diseased veins have been blocked, blood flow is redirected towards healthy veins in the scrotum. Blood no longer pools inside the damaged vessels.
Most men can resume work within two days following their procedure and exercise after 10 days. Both surgical and embolization procedures come with an approximate 90 percent success rate, but recovery is quicker with embolization and there are also fewer risks.
Men who are not candidates for surgery can usually undergo an embolization procedure. However, whether you should undergo a varicocele embolization procedure or a different treatment should be discussed with your medical team.
Preparing for Varicocele Embolization
During one of your initial appointments at our Phoenix, AZ clinic, we will provide you with detailed instructions on preparing for this procedure.
We will review your medical history thoroughly and perform blood work and other medical testing to confirm that varicocele embolization is right for you. You will need to disclose which medications you are currently on, if any, including dietary supplements.
We may ask you to stop taking blood-thinning medication and supplements, like aspirin, Warfarin and vitamin E, for a couple of days before your procedure. You will also need to avoid all food and drink on the night before your procedure and have someone ready to take you home upon your discharge.
Symptoms of BPH can include:
- Frequent urination
- Nighttime urination
- Slow urination or dribbling
- Urinary hesitancy (difficulty starting urination)
- Urinary urgency (sudden need to urinate)
- Pain with ejaculation or while urinating
- Change in the color/smell of urine
While BPH may sound troublesome, the condition is fairly prevalent. BPH is the most common prostate condition in men. Almost all men develop it eventually, with statistics showing a 50 percent prevalence rate by age 60 and an over 90 percent prevalence rate in men over 85 years of age.
BPH does not always cause symptoms. Men who experience no symptoms or mild symptoms usually do not require any treatment other than “watchful waiting” — monitoring to ensure that the condition is not worsening.
If symptoms are severe, men can choose between medications, surgery and minimally invasive treatments like prostate artery embolization.
Like all medical procedures, varicocele embolization comes with both risks and benefits.
- As a minimally invasive alternative, there is no need for extensive incisions, stitches and general anesthesia
- Recovery is quick, usually within two days to a week
- Has the same success rate as surgical treatments but with fewer risks and quicker recovery
- Recurrence of varicocele is rare, occurring in only 10 percent of treated men
- Like any invasive or minimally invasive procedure, there is a small risk of infection
- Inflammation of the scrotum and veins
- Bruising at the entry size and scrotum, although this should subside within a couple of weeks
- Allergic reactions to the contrast material used during x-ray imaging or sedative/anesthetic medication
- Damage to nearby tissue due to the embolic agent lodging in the wrong place
- Slightly increased risk of cancer due to radiation used during the procedure
Learn More About Varicocele Embolization
If you have been diagnosed with a varicocele that is causing you discomfort, pain or infertility, and you prefer a minimally invasive treatment option, speak with a doctor about varicocele embolization. This proven, highly effective procedure has excellent treatment outcomes without the drawbacks of open surgery.
The team at Vascular and Interventional Partners has a rich history of involvement in education and research, and a track record of success using minimally invasive techniques to treat patients with a variety of conditions. We invite you to schedule a consultation through our contact form or by calling us today at (480) 435-9100.
Frequently Asked Questions
Who is a candidate for varicocele embolization?
If you are an adult male diagnosed with symptomatic varicocele, you may be a good candidate. Before considering you for this procedure, we will carefully take a look at your medical history and perform medical exams to rule out any conditions that may make it dangerous for you to undergo a varicocele embolization.
How long does varicocele embolization take?
Varicocele embolization typically takes no longer than an hour to complete. Additional time is needed to prepare for and recover from the procedure, but you should be in and out of the facility within the same day.
Is varicocele embolization better than surgery?
Not necessarily. While less invasive and generally safer, more severe cases should be treated with a varicocelectomy and other surgical procedures.
How successful is varicocele embolization?
Success rates for varicocele embolization and surgical treatment are the same — around 90 percent. Most men notice less pain following both treatment modalities, and there is mild to moderate improvement of fertility.
Does varicocele embolization affect testosterone?
Men with varicocele may have lower testosterone levels as a result of their condition, although within normal ranges. Treatment leads to improvement in testosterone levels in over 80 percent of men.
Can varicocele embolization lead to erectile dysfunction?
In short, no. But it may improve erectile dysfunction in rare cases where a varicocele has caused a severe dip in testosterone levels.