Varicocele Embolization

What is varicocele embolization?

Varicocele embolization is a type of medical procedure. It redirects blood away from an enlarged vein in your scrotum. Such an enlarged vein is called a varicocele. It can cause pain, infertility, and swelling. A radiologist uses a coil or special agents to block (embolize) the vein. This can help improve symptoms.

Your scrotum is the sac that contains your testes, blood vessels, and part of your spermatic cord. Sperm are normally made in the testes. They travel through the spermatic cord’s duct system. From there, the sperm are ejaculated through the urethra.

A varicocele is an abnormal enlargement of the group of veins in your scrotum. These veins are similar to varicose veins found in the legs. Poorly functioning valves in these veins may cause the vessels to swell.

Why might I need varicocele embolization?

Varicoceles often don’t have any symptoms. In teens, they may cause slowed growth of the testicles. They may also cause pain and swelling. And they can also lead to infertility. You may get treatment due to your symptoms or because of infertility.

Surgery and varicocele embolization are the two main treatments. Both choices have similar success rates. But the recovery time from embolization is often shorter. That’s because it uses only a tiny needle stick. You also don’t need to be put to sleep for it.

Surgery might be a better choice if you have varicocele affecting both testicles. Talk with your healthcare provider about the choice that makes the most sense for you. Varicocele embolization might not be available in your area.

What are the risks of varicocele embolization?

The procedure is safe. Some very rare risks are:

  • Infection

  • Allergic reaction

  • Excess bleeding

  • Migration of the coil sometimes used to block the enlarged vein

  • Lower back pain

  • Inflammation of the scrotum

  • Inflammation of the vein

  • Nausea

There is also a chance that the procedure won’t work. Your varicocele may also come back. It may do so even if the first treatment was successful.

Your own risks may a little different. They may depend on your age and any other health problems you may have. The anatomy of your varicocele can also affect your risk. Be sure to talk with your healthcare provider about all your concerns before the procedure.

How do I get ready for varicocele embolization?

Your healthcare provider will tell you how to prepare for the procedure. Tell your provider about the following:

  • Your health history

  • Any past problems with medicine allergies or contrast dye

  • Any recent symptoms, such as a fever

  • Any medicine you are taking, including over-the-counter and prescription medicines, vitamins, herbs, and other supplements

If you smoke, you should stop smoking beforehand. That will lower your chance for problems. Follow any directions you are given for not eating or drinking before your procedure. Make sure someone is available to drive you home afterward.

You may need other tests before your procedure. For example, you might need an ultrasound of your scrotum. It can provide more details about your varicocele.

What happens during varicocele embolization?

Your healthcare provider will tell you what to expect during varicocele embolization. The procedure may take a few hours. In general, you might expect the following:

  • You’ll likely first be given medicine to make you relaxed and sleepy.

  • Your healthcare team will carefully watch your heart rate and blood pressure.

  • You will receive a shot of numbing medicine into an area on the inner part of your upper thigh. The shot will stop you from feeling much during the procedure.

  • Your healthcare provider will clean the area. They will then put a needle into your inner thigh to access a major vein. They will insert the catheter tube into this vein.

  • X-rays will help your provider move the tube to the correct area in your scrotum. They may inject X-ray dye (contrast) into the vein. This will help provide clearer X-ray images. You may feel some warmth.

  • Your healthcare provider will release a small coil or a special liquid into the affected vein. This is called a blocking agent. It often redirects blood flow into other nearby veins. The blood can then exit the scrotum normally. If successful, the varicocele will go away.

  • Afterward, the catheter will be removed. A bandage will be placed over the area of entry on your thigh.

What happens after varicocele embolization?

You’ll be carefully watched for some time after the procedure. In most cases, you’ll be able to go home the same day. Your healthcare provider will tell you if the procedure successfully fixed the affected veins.

You may need to take it easy for the rest of the day. But you should be able to do your normal activities the next day. If you took medicine to help you relax, you shouldn’t drive or make any important decisions for at least 24 hours. You will likely need to wait longer before doing more strenuous activities, such as jogging. You may also need to not have any sexual activity for a few weeks.

Tell your healthcare provider if you have any problems after the procedure. These include warmth and redness at the injection site.

After the procedure, you will need to follow up with your healthcare provider. Many people note less pain soon afterward. If you were having problems with infertility, you may need a semen analysis. It can tell if your fertility has increased. In some cases, you might need a repeat procedure or surgery if your varicocele comes back.

Next steps

Before you agree to the test or procedure make sure you know:

  • The name of the test or procedure

  • The reason you are having the test or procedure

  • What results to expect and what they mean

  • The risks and benefits of the test or procedure

  • What the possible side effects or complications are

  • When and where you are to have the test or procedure

  • Who will do the test or procedure and what that person’s qualifications are

  • What would happen if you did not have the test or procedure

  • Any alternative tests or procedures to think about

  • When and how will you get the results

  • Who to call after the test or procedure if you have questions or problems

  • How much you will have to pay for the test or procedure

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