A varicocele is a testicular problem that causes discomfort and can cause infertility if not treated. However, it’s important to know that surgery is not your only option. You may be a candidate for a non-surgical treatment option called varicocele embolization, which blocks off the blood flow into these problem veins. At CDI Vascular Care, we perform this highly effective procedure in about an hour with a small incision and minimal recovery time.
What are Varicoceles?
Varicoceles are enlarged varicose veins around the testicle that can cause pain and swelling.
This condition affects 15 out of 100 men overall and 40 out of 100 men with known infertility. Varicoceles are most common in young men, usually in their 20s and 30s. Although varicoceles can be found in both the left and right testicle, they are most often found in the left.
Some men do not have symptoms, and their varicocele does not affect fertility or function. In this case, they often require no treatment. However, enlarged veins can cause swelling and pain that can worsen over time and eventually cause problems with infertility and sperm quality. They are often discovered during a fertility evaluation or a routine physical exam.
What You Need To Know
- Testicular pain, cramping, and swelling
- Testicular atrophy (shrinkage of the testicle)
There are two primary tests to diagnose varicoceles; ultrasound, and venogram.
Ultrasound uses high-frequency sound waves to create precise images of structures inside your body. It can be used to identify smaller varicoceles that may not be found via a clinical exam alone. A venogram uses X-ray and contrast material, a special dye that is injected into the veins to “highlight” blood vessel abnormalities. We use venography to identify abnormal veins and to guide treatment of the varicocele.
Varicocele embolization is an outpatient, image-guided procedure that uses a catheter to place a tiny coil and/or medication into the problem blood vessel to divert blood flow away from the varicocele. Unlike varicocele surgery, embolization requires no incision, stitches, or general anesthesia. Several studies have shown that embolization is just as effective as surgery and recovery is significantly less. Patients can return to full activities in a day or two, while surgery patients may need to avoid strenuous activity for several days or even weeks. Most insurance will cover varicocele embolization if they cover varicocele surgery.
Benefits of Embolization
- No surgical incision in scrotal area
- As effective as varicocele surgery at improving semen analysis and pregnancy rates
- Patients can return to normal daily activities immediately
- No required hospital admittance
- Though rare, varicoceles occurring on both sides can be fixed simultaneously through one vein puncture site
- No general anesthesia required
- No sutures
- Reduced chance for infection
Varicocele surgery, commonly called varicocelectomy or surgical ligation, is typically performed by a urologist. An incision is made in or near the scrotum down to the testicular veins, which are tied off with sutures. Most patients require two to six weeks of recovery time. The success rate of surgery is equivalent to that of embolization but requires much longer recovery time.
What To Expect
Once we work with you to determine a treatment plan, one of our vascular staff or interventional radiologists will review any pre- and post-instructions for your procedure. You will be walked through your procedure so you know exactly what to expect.