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Varicocele

Varicocele without surgery

A varicocele is an enlargement of the veins within the scrotum, the loose bag of skin that holds your testicles. A varicocele is similar to a varicose vein that can occur in your leg. It is present in approximately 10% of young men.

Treatment

Surgical ligation: performed under general anesthesia either traditional, laparoscopic or microscopic surgery.
Varicocele embolization is a minimally invasive, image-guided procedure that uses a catheter to place a tiny coil and/or embolic fluid in a blood vessel to divert blood flow away from a varicocele. It is performed without general anesthesia or surgical wound

Varicocele embolization Procedure

Varicocele embolization is an outpatient procedure that is performed without general anesthesia using twilight sedation. In this procedure, a small tube is inserted into the arm vein (just like having an IV line). The skin is numbed for this procedure and it is not painful. Next, a small catheter, or tube, is painlessly guided into the abdomen and into the varicocele vein under the guidance of x-ray imaging (see Figure). The vein is then intentionally closed off by plugging it with small metals coils and a special medication (the same sclerosant medication injected into leg varicose veins). The procedure takes 30 minutes and the patient goes home immediately after with only a band aid at the puncture site. Patients can drive or travel immediately. They can immediately resume their non-exertional activities.

Advantages of Varicocele embolization include:

  • Performed under local anesthesia with mild sedation (general anesthesia used for surgical varicocele ligation). No surgical incision in the groin.
  • Lower rate of complications compared to surgery. Infection has not been reported after embolization.
  • Performed on an outpatient basis.
  • Can resume normal intercourse a day after (after surgery, patient need weeks).
  • It is as effective as surgery, as measured by improvement in pain, semen analysis and pregnancy rates.
  • Varicocele embolization safely relieves that pain and swelling and may improve sperm quality for infertile couples.

  

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