A varicocele is an enlargement of the veins within the scrotum. It is similar to a varicose vein in the leg and may cause pain, testicular shrinkage, and/or fertility problems. Varicoceles are predominantly seen in men between the ages of 15 and 35. A varicocele embolization is a minimally-invasive, image-guided procedure that redirects blood flow away from the varicocele.
The symptoms of a varicocele include:
- Painful testicles
- Atrophy shrinking
- Fertility difficulties
Many men experience aching pain after standing or sitting for long periods of time because pressure builds up on the affected veins. Typically, painful varicoceles are enlarged. Other men notice the size of their testicles decrease, but once the testicle is repaired, it frequently returns to normal. There may also be a relationship between varicoceles and infertility as noted in:
- Decreased sperm count
- Decreased motility of sperm
- Increase numbers of deformed sperm
Diagnosis and Treatment
A diagnosis is made by means of a physical exam or diagnostic imaging. Physically varicoceles typically occur on the left side of the scrotum and the testicles are shrunken in size or atrophy. However, varicoceles are not always physically obvious. In that case, irregular blood flow can be detected with an ultrasound or x-ray called a venogram.
Surgical ligation tends to be the most common treatment for varicoceles, but an alternative treatment option is varicocele embolization. A minimally invasive treatment performed by an interventional radiologist. The procedure is as successful as surgery with less risk, pain, and recovery time. Varicocele embolization is also advantageous for patients with varicoceles in both testicles; they can both be corrected utilizing one incision, whereas surgery requires two. It often has the added benefit of effectively improving male infertility.
The procedure is a catheter-directed outpatient treatment that requires only minor sedatives and local anesthesia. The procedure is relatively easy. A catheter is guided through the femoral vein to the testicular vein, then contrast dye is inserted to highlight the veins so the physicians can locate the problem and embolize the vein. By embolizing the vein, blood flow is redirected to healthy pathways. Essentially, the useless vein is shut off internally, accomplishing what urologists do, but without surgery.
Once the procedure is complete, you spend an hour or two in recovery and then are permitted to go home. It is recommended that you limit physical activity for about three to four days after the procedure. With surgery, recovery time can last approximately two to three weeks.