Columbia Radiology's interventional radiologists have extensive experience with a minimally invasive approach to the treatment of varicoceles—a common condition in men that involves enlarged or swollen veins in the scrotum (the sac that holds the testicles).
Varicoceles are usually easy to diagnose, either with a physical exam or an ultrasound. They are often described as a "bag of worms". Many men experience no symptoms from their varicoceles, and many do not need treatment. Treatment for varicoceles is recommended when they cause:
- symptoms, such as discomfort, pain, or swelling
- a decrease in fertility
- decreased testosterone production by the testis
A consultation with an interventional radiologist can help determine whether varicocele embolization is the right treatment for your varicoceles.
Varicocele Treatment at Columbia Interventional Radiology
Interventional radiologists treat varicoceles using a minimally invasive procedure called embolization. Varicocele embolization has similar results to open surgery and involves much less recovery time. Most of our patients go home on the day of their procedure with a Band-aid instead of an incision.
During this procedure an interventional radiologist uses X-ray imaging to navigate a catheter (a thin, hollow tube) to the veins in the testicle. Small metallic coils are then placed through the catheter and into the veins. The coils block the blood flow through the enlarged vein, causing it to 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 small metallic coils into 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.