A varicocele is an enlarged or dilated group of veins in the scrotum (the sac that holds the testicles). Varicoceles occur when valves in the scrotal vein malfunction and blood pools, causing the veins to become varicose (swollen). Many men experience no symptoms from their varicoceles, but they should be treated because they can cause infertility. Interventional radiologists treat varicoceles using a minimally invasive procedure called embolization.
What is varicocele embolization?
Embolization is a minimally invasive, outpatient procedure in which we block (occlude) the veins that form the varicocele. Once the blood flow through the varicocele is stopped, it should shrink and eventually disappear.
How do I get ready for the procedure?
On the night before the procedure eat a light meal, then do not eat or drink anything after midnight. We will provide you with more detailed information about which medications you may take in days before and on the morning of the procedure. Plan to have someone drive you home after the procedure.
What will happen during the procedure?
After you arrive at the interventional radiology suite and change into a gown, you will lie face up on the procedure table. To relax you and block any pain we will intravenously give you a combination of medicines called “conscious sedation.” Using X-ray and/or ultrasound image guidance, we will insert a long, very thin tube called a catheter through a small incision into the femoral vein in the groin or into the jugular vein in the neck. We will then inject a contrast dye through the catheter to make the varicocele and the blood vessels that supply it visible on the X-ray. Using the catheter, we will advance a synthetic material called an “embolic agent” (an FDA-approved polyacrylamide microspheres with a gelatin coating) to the veins, and block them with it. The entire procedure takes about an hour.
Are there any risks?
Complications from varicocele embolization are rare but include bruising at the catheter insertion point, backache, and, rarely, nausea.
After the procedure
We will keep you in the recovery area until any bleeding at the insertion point has stopped and your vital signs are normal. You should arrange for a ride home. After returning home, rest for 24 hours, and avoid lifting anything more than 10 pounds for three to five days. We will give you additional instructions before you go home from the interventional radiology suite.