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Varicocele Embolization– for Patients

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Varicocele Embolization– for Patients Varicocele Embolization– For Patients What is a varicocele? A varicocele is a network of tangled blood vessels (varicose veins) in the scrotum that is caused by reverse blood flow. Normally, blood in the testicles goes through a series of small veins and is eventually emptied into a large vein that goes up through the abdomen. Sometimes the valves in this vein fail and the blood flows back into the testicles, instead of up to the heart. Varicoceles occur most often in young men in their twenties or thirties and can cause pain, infertility, or testicular atrophy (shrinkage). What are the advantages of varicocele embolization versus varicocele surgery? Unlike varicocele surgery, varicocele embolization requires no incision, stitches, or general anesthesia. Further, embolization patients almost never require overnight admission to the hospital. In addition, several studies have shown that embolization is just as effective as surgery. Studies have also shown that embolization patients return to full activities in a day or two. In one study, patients who underwent both varicocele surgery and embolizaton for varicocele repair, overwhelmingly favored embolization. Should all varicoceles be repaired? Not necessarily. If you have symptoms, such as pain, you may choose to have a varicocele repair procedure sooner. But an asymptomatic varicocele is a common condition that does not necessarily cause pain or infertility. A varicocele only needs to be fixed when it causes pain, shrinkage of a testicle, or when it is associated with male infertility. Will varicocele embolization improve my semen analysis? Many studies have shown that varicocele repair can improve semen analysis significantly, but there is no guarantee that any individual patient will experience a significant improvement. Pregnancy rates in infertile couples improve after varicocele repair by about 30-50 %. Will the varicocele repair procedure reduce any pain? Successful varicocele repair reduces the swelling and discomfort of symptomatic varicoceles. There are other causes of scrotal pain that may need to be ruled out before varicocele treatment. What are the risks or complications of the procedure? Minor complications such as bruising at the catheter site, nausea or low grade backache may occur, but are uncommon. Rarely, epididymitis can occur, which is typically a self-limiting treatable infection of the spermatic duct. Infection, hydrocele or loss of a testicle have not been reported after coil embolization. Is the procedure painful? It is not a painful procedure. Will I be put to sleep (under anesthesia) during the procedure? The procedure is performed with local anesthesia and “twilight” sedation. How long will I be in the hospital after the procedure? Typically, patients are observed for a few hours and go home the same day. What are my restrictions after the procedure? Patients are instructed to rest quietly at home on the day of the procedure. They may resume normal activity the next day. They may resume strenuous and extertional activities, such as jogging, heavy lifting, and sex in 10-14 days as determined by the radiologist. Varicocele surgery often has a longer recovery time. How much work will I miss? While every patient is different, recovery from varicocele embolization typically takes less than 24 hrs and many patients return to work the next day. Will the procedure affect sexual function? No. However, no sexual activity for 10-14 days as determined by the radiologist. Is there a chance that the varicocele will recur after varicocele repair? There is a 5-11% chance that a varicocele could recur after embolization. If so, surgery may be needed. Keep in mind that a varicocele may also recur after surgery. I had varicocele surgery but my varicocele has come back. Can varicocele embo help me? Yes. Embolization is highly effective way to repair varicocele after varicocele surgery. What does varicocele embolization cost? The cost is generally comparable to varicocele surgery. However, the cost varies depending on the local insurance company policies. Will my insurance pay for varicocele embolization? Generally, insurance companies will pay for the varicocele embolization if they pay for varicocele surgery. However, check with your insurance company about this. If X-rays are used to guide varicocele embolization, is there a danger of radiation exposure? Although the radiologist guides the catheter with an X-ray machine during embolization, the amount of radiation exposure to the testicle is very low - about equal to the amount received during a chest X-ray. If I have other questions, who do I contact? For further questions or concerns about varicocele embolization, please contact Interventional Radiology at 205-934-0152, 205-934-7245, 205-975-4850. .
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