A varicocele is a collection of dilated (swollen) veins in the scrotum, similar to varicose veins in the leg. It is caused by an abnormality in the testicular veins which take blood away from the testicle back to the heart. A varicocele embolisation is a minimally-invasive pin-hole procedure used to treat the symptoms associated with a varicocele. It has a high success rate and low levels of risk.
If you have a varicocele that is causing symptoms, your doctor may recommend treatment. There are two approaches to treating varicoceles – embolisation and surgery. While both are effective, embolisation is generally considered the first line treatment.
This is because it is minimally invasive and performed under local rather than general anaesthetic. This means recovery times are faster and the risk of complications is lower. In a small number of cases, surgery may be recommended instead but your consultant radiologist will discuss this with you.
A man’s scrotum is the sac that contains the testes, blood vessels and part of the spermatic cord. If the testicular vein, which drains blood from the testicle back to the heart, is not functioning correctly, it can become swollen.
Varicoceles are fairly common and may or may not cause symptoms. If they are asymptomatic (without any symptoms), we generally advise against treatment. Men who do develop symptoms may experience a dragging sensation, ache or pain in the scrotum. In fact this is often made worse by standing or sitting for long periods.
You may also notice a small lump in the testicle. Varicoceles are sometimes linked to a reduced sperm count, which normally improves after treatment.
A doctor performing a varicocele embolisation passes a pin-hole needle and thin plastic tube into your neck or groin and down into the testicular vein. Once it is correctly positioned, your doctor feeds a series of fine metal coils into the testicular vein. This blocks it permanently. They may also inject a special fluid to block off the vein.
A varicocele embolisation is a day-case procedure which means you can go home the same day. It is performed in the X-ray department by a Consultant Radiologist. Your doctor will give you a local anaesthetic. This means you will be awake throughout but unable to feel pain. In addition the doctor may give you sedation to help you relax.
The procedure normally takes 30-60 minutes and is carried out by a specially trained Consultant Radiologist. A cannula (thin plastic tube) will be inserted into a vein in your hand or arm so we can give you medication during the procedure, if necessary.
Before your varicocele embolisation you should not eat for at least four hours. However, You will be able to continue drinking water for up to two hours beforehand.
Afterwards you should be able to go home after around 1-2 hours. However, you shouldn’t drive yourself if you’ve had a sedative. In fact someone will need to stay with you for 24 hours. You should rest for 24 hours and avoid vigorous exercise for about a week.
Some patients experience a slight ache in the groin or abdomen afterwards but this normally goes away after a few days. In the meantime, you can take painkillers or anti-inflammatories.
A varicocele embolisation has an 80-90% success rate. In some cases, the varicocele may return within a few years, which may require further treatment.
Varicocele embolisation is a very safe procedure. Rarely, you may develop an infection or an allergic reaction to the agents that are injected. In addition, some patients experience inflammation of the vein or scrotum or excess bleeding. Your doctor will discuss the risks with you prior to undergoing the procedure.
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