Varicocele Embolization

• A varicocele is an enlargement of the veins in the scrotum (sac around the testicles).

• It can occur on both sides but is most common on the left side.

• Varicoceles usually form during puberty and develop over time.

• They can result in poor development of a testicle, low sperm production, and fertility issues.

• Among men with fertility issues; about 40% have a varicocele.

Causes

The exact cause of a varicocele is unknown.

One factor may be the malfunction of valves inside the veins that are intended to keep blood moving in the right direction from the testicle back to the heart. When this oxygen-depleted blood gets backed up in the veins, these veins dilate creating a varicocele.

Physical Signs/Symptoms

• Painless lump or bulge

• Dull ache, discomfort, or pain especially when standing or late in the day

• Laying down sometimes relieves symptoms if present

Diagnosis

• Physical Exam

• Testicular/Scrotal Ultrasound

Treatment

There are 2 options including surgery and non-surgical varicocele embolization. Many prefer varicocele embolization because it’s an outpatient, non-surgical treatment with a high success rate and no surgical incisions.

Varicocele embolization begins with light sedation and pain medications which are given for relaxation and pain control. A vein in the neck or groin is then accessed using local anesthesia and an ultrasound camera. Then using fluoroscopy, a catheter is inserted through this vein into the varicocele. The varicocele is then embolized or blocked off to close it. Over the course of several months, symptoms and sperm count improve.

The procedure can take anywhere from 1 to 2 hours depending on the location, number, and size of the varicocele(s). Patients walk out of the treatment center the same day and can drive the next day.