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Varicocele Treatment

A Varicocele is a varicose vein of the testicle and scrotum that may cause pain, testicular atrophy (shrinkage) or fertility problems. Veins contain one-way valves that work to allow blood to flow from the testicles and scrotum back to the heart. When these valves fail, the blood pools and enlarges the veins around the testicle in the scrotum to cause a varicocele. Varicocele embolization, a nonsurgical treatment performed by your CiC physician, is a highly effective technique to treat symptomatic varicoceles.

Prevalence

  • Approximately 10 percent of all men have varicoceles. Among infertile couples, the incidence of varicoceles increases to 30 percent.
  • Highest occurrence in men aged 15-35
  • As many as 70-80,000 men in America may undergo surgical correction of varicocele annually.

Varicocele Symptoms

Pain

Aching pain when an individual has been standing or sitting for long periods of time and pressure builds up on the affected veins. Typically, though not always, painful varicoceles are prominent in size. Pain can also worsen with exercise.

Fertility Problems

There is an association between varicoceles and infertility. The incidence of varicocele increases to 30 percent in infertile couples. Decreased sperm count, decreased motility of sperm, and an increase in the number of deformed sperm are related to varicoceles. Some experts believe these blocked and enlarged veins around the testes cause infertility by raising the temperature in the scrotum and decreasing sperm production.

Testicular Atrophy

Shrinking of the testicles is another sign of varicoceles. Once the varicocele is treated, the testicle may return to normal size.

Efficacy

Embolization is equally effective in improving male infertility as surgical ligation. Pregnancy rates and recurrence rates are comparable to those following surgical varicocelectomy. In one study, sixty percent conceived who were treated for infertility.

In another study, sperm concentration improved in 83 percent of patients undergoing embolization compared to 63 percent of those surgically ligated. Patients who underwent both procedures expressed a strong preference for embolization.

Varicocele embolization

This is a nonsurgical, outpatient treatment performed by your CiC physician using imaging to guide catheters or other instruments inside the body. Using mild IV sedation and local anesthesia, patients are relaxed and pain-free during the approximately two-hour procedure.

For the procedure, your CiC physician makes a tiny nick in the skin at the neck or groin using local anesthesia, through which a thin catheter (much like a piece of spaghetti) is passed into the abnormal vein. The physician then injects contrast to provide direct visualization of the veins and map out exactly where the problem is. By using coils or plugs, the physician blocks the blood flow in the abnormal vein(s), which reduces pressure on the varicocele. By embolizing the vein, blood flow is redirected to other, healthy pathways.

Recovery Time

  • Average of one to two days for complete recovery for embolization, compared to two to three weeks for surgery.
  • 24 percent of surgical ligation patients required overnight hospital stay, compared to none for embolization.

Benefits of Embolization

  • No surgical incision in the scrotal area
  • Effective as surgery, as measured by improvement in semen analysis and pregnancy rates
  • Less recovery time – patients are able to return to normal daily activities immediately and without hospital admittance
  • A patient with varicoceles on both sides can have them fixed through one vein puncture site, compared to surgery, which requires two separate open incisions
  • No general anesthesia
  • No sutures