This is an abbreviated version of the complete article.*
Basic Facts
Varicocele embolization is an interventional radiology treatment for varicoceles, which are varicose veins in the scrotum.
The procedure is an outpatient procedure, performed with local anesthesia and light sedation.
Treating varicoceles can improve sperm quality in men who experience fertility problems and it can relieve pain.
A varicocele is a swollen vein in the scrotum.
A varicocele is a varicose vein in the scrotum. Varicoceles can cause pain, swelling, and infertility.
Embolization is a procedure in which interventional radiologists intentionally block a blood vessel to divert blood flow. Physicians have used embolization to treat varicoceles since the 1970s.
In varicocele embolization, the physician inserts a catheter into a vein through a tiny nick in the skin. The catheter is guided through the blood vessels to the varicocele. The physician deploys embolic materials through the catheter, blocking the varicocele-causing vein and diverting blood to healthy veins.
Varicocele embolization safely relieves pain and swelling and may improve sperm quality. The recovery time is shorter with embolization than with surgery.
WHEN IS IT INDICATED?
Varicocele embolization is indicated if a varicocele:
Is associated with infertility;
Causes pain;
Recurs; or
Occurs in childhood or adolescence.
PRE-TREATMENT GUIDELINES
The patient should inform the physician of an allergy to an iodinated contrast agent before the procedure.
For 6 hours before the procedure, patients should not eat or drink.
The patient may be given a mild sedative before the procedure.
WHAT TO EXPECT
Varicocele embolization is performed in an interventional radiology suite. The interventional radiologist cleanses the skin above the insertion point, and applies a local anesthetic. Intravenous sedation is typically given. During the procedure, the physician takes venograms to see the catheter moving through the blood vessels. Because there are no nerve endings in blood vessels, the patient is unable able to feel the catheter.
Once the catheter is properly positioned, the interventional radiologist deploys embolic agents to block the vein. Steel or platinum coils are most commonly used, although some physicians prefer liquid agents that harden the veins. After the vessel has been successfully blocked, the catheter is removed and pressure is applied to prevent bleeding. No stitches are needed.
Varicocele embolization takes approximately 30 to 40 minutes.
POST-PROCEDURE GUIDELINES AND CARE
The patient is monitored for a few hours and released. The patient should be driven home. Most patients resume normal activities within 24 hours of the procedure.
POSSIBLE COMPLICATIONS
The majority of varicocele embolizations cause no complications. The most common complication is bruising at the insertion point. Other possible complications include:
Lower back pain;
Phlebitis; and
Movement of coils or balloons to a lung (this is very rare).
In approximately 5 to 10 percent of patients who undergo varicocele embolization, the varicoceles return.
Medical Review Date: February 8, 2005
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