Non-Surgical Treatment for Varicocele and Male Infertility
A varicocele is a testicular problem that causes discomfort and even infertility, but it’s important to know that surgery is not your only option. You may be a candidate for a non-surgical treatment option called varicocele embolization, which blocks off the blood flow into these problem veins. At CDI Vascular Care, we perform this highly effective procedure in about an hour with a small incision and minimal recovery.
What are Varicoceles?
Varicoceles are enlarged varicose veins around the testicle. They are usually discovered during a fertility evaluation or a routine physical exam and are fairly common, affecting 15 out of 100 men overall and 40 out of 100 men with known infertility. Varicoceles are most common in young men, usually in their 20s and 30s. Although varicoceles can be found in both the left and right testicle, they are most often found in the left. Often they cause no symptoms nor do they affect fertility or function. In this case, they often require no treatment. However, enlarged veins can cause swelling and pain that can worsen over time and eventually cause problems with infertility and sperm quality.
Symptoms of Varicoceles can include:
- Testicular pain, cramping and swelling
- Testicular atrophy (shrinkage of the testicle)
Diagnosis of Varicoceles
There are two primary tests to diagnose Varicoceles. Ultrasound uses high-frequency sound waves to create precise images of structures inside your body. It can be used to identify smaller varicoceles that may not be found on a clinical exam alone. A venogram uses X-ray and contrast material or special dye, which is injected into the veins to "highlight" blood vessel abnormalities. We use venography to identify the abnormal veins and to guide treatment of the varicocele.
What to Expect During Varicocele Embolization
When you have a varicocele embolization procedure, a catheter is placed into a vein in either your leg or neck and then it’s advanced into the gonadal veins that supply the testicle. Next, X-ray contrast material is injected through the catheter and X-ray images taken. You may be asked to hold your breath for several seconds as these pictures are taken. During the injection of X-ray contrast material, you may experience a warm feeling or a strange taste in your mouth. Both sensations are temporary and will go away quickly. The gonadal veins are closed using a procedure called embolization and sclerotherapy. Embolization involves injecting small metal devices called coils that stop blood flow in the abnormal veins. Sclerotherapy is the injection of a drug, which destroys smaller veins that cannot be treated with coils. The body will then reroute the blood flow into more normal veins.
Varicocele Surgery vs. Varicocele Embolization
Varicocele surgery, commonly called varicocelectomy or surgical ligation, is typically performed by a Urologist. An incision is made in or near the scrotum down to the testicular veins, which are tied off with sutures. Most patients require two to six weeks of recovery time. The success rate of surgery is equivalent to that of embolization but requires a much longer recovery time.
Varicocele embolization is an outpatient, image-guided procedure that uses a catheter to place a tiny coil and/or drugs into the problem blood vessel to divert blood flow away from the varicocele. Unlike varicocele surgery, embolization requires no incision, stitches, or general anesthesia. Several studies have shown that embolization is just as effective as surgery and recovery is significantly less. Patients can return to full activities in a day or two, while surgery patients may need to avoid strenuous activity for several days or even weeks. Most insurance will cover varicocele embolization if they cover varicocele surgery.
Benefits of Embolization
- No surgical incision in scrotal area
- As effective as varicocele surgery at improving semen analysis and pregnancy rates
- Patients can return to normal daily activities immediately
- No required hospital admittance
- Though rare, varicoceles occurring on both sides can be fixed simultaneously through one vein puncture site
- No general anesthesia required
- No sutures
- Reduced chance for infection
Schedule a Consultation
To learn more about whether varicocele embolization is right for you, fill out this form and we will call you to schedule a consultation, or get in touch with us at 952-738-4477.