AUSTIN RADIOLOGICAL ASSOCIATION

ARA CONVENIENCE Exceptional patient care Most insurance plans accepted and filed What is ? Flexible office hours Handicapped-accessible parking Varicocele A varicocele is a varicose of the AUSTIN CENTER BOULEVARD ROCK CREEK PLAZA and that may cause pain, testicular 6818 Austin Center Boulevard 2120 N. Mays Suite 101 Suite 220 atrophy (shrinkage), or fertility problems. Austin, TX 78731 Round Rock, TX 78664 (512) 795-8505 (512) 238-7195 contain one-way valves that work CEDAR PARK & CEDAR PARK SAN MARCOS Non-surgical treatment to allow to flow from the WOMEN’S IMAGING 1348 B Texas 123 South 12800 W. Parmer Lane San Marcos, TX 78666 and scrotum back to the heart. When these Suite 200 (512) 392-1831 or for Cedar Park, TX 78613 (888) 261-2149 (512) 485-7199 valves fail, the blood pools and enlarges SOUTHWEST MEDICAL VILLAGE CHILDREN’S IMAGING CENTER 5625 Eiger Road the veins around the testicle in the scrotum 1301 Barbara Jordan Blvd. Suite 165 Suite 104 Austin, TX 78735 to cause a varicocele. Austin, TX 78723 (512) 519-3475 (512) 480-0761 SOUTHWOOD DRIPPING SPRINGS 1701 W. Ben White Boulevard Approximately 10 percent of all men have 170 Benney Lane, Suite 101 Suite 170 Dripping Springs, TX 78620 Austin, TX 78704 varicoceles – among infertile couples the (512) 776-1176 (512) 428-9090 incidence of varicoceles increases to 30 GEORGETOWN WESTLAKE 3201 S. Austin Avenue 5656 Bee Caves Road percent. The highest occurrence is in men Suite 105 Building H, Suite 200 Georgetown, TX 78626 Austin, TX 78746 aged 15-35. As many as 70-80,000 men (512) 863-4648 or (512) 328-4984 (512) 519-3441 WILLIAM CANNON in America may undergo surgical correction KYLE & KYLE WOMEN’S 2501 W. William Cannon Drive IMAGING CENTER Building 5 of a varicocele annually.* 4211 Benner Road, Suite 100 Austin, TX 78745 Kyle, TX 78640 (512) 346-7311 *Society of (512) 776-1150 WILSON PARKE MEDICAL PARK TOWER 11714 Wilson Parke Ave. 1301 W. 38th Street Suite 175 Suite 118 Austin, TX 78726 Austin, TX 78705 (512) 519-3457 (512) 454-7380 WOMEN’S IMAGING CENTER - MIDTOWN I CENTRAL 901 W. 38th Street 1600 W. 38th Street Suite 100 Suite 100 Austin, TX 78705 Austin, TX 78731 (512) 519-3456 (512) 275-0013 QUARRY LAKE Varicocele embolization 4515 Seton Center Parkway procedure location Suite 105 Austin, TX 78759 (512) 519-3402

Aug 2019 SCHEDULING FAX REFERRALS (512) 467-9729 (512) 343-9099

www.ausrad.com Embolization and surgical ligation are equally effective in About interventional radiologists improving male and cost about the same. Pregnancy Interventional radiologists are doctors who specialize in rates and recurrence rates are comparable to those following minimally invasive, targeted treatments performed using surgical ligation. imaging guidance. They use their expertise in reading x-rays, ultrasound, MRI, and other diagnostic imaging to guide tiny Approximately 40 percent of cases of primary instruments, such as catheters, through blood vessels or are believed to be due to varicoceles.* Patients who underwent through the skin to treat diseases without surgery. both embolization and surgical ligation procedures expressed a strong preference for embolization. Interventional radiologists are board-certified and fellowship- trained in nonsurgical interventions using imaging guidance. Benefits of embolization The American Board of Medical Specialities certifies their • Less recovery time – An average of 1 to 2 days for complete training. recovery compared to 2 to 3 weeks for surgery. You will be able to return to normal daily activities immediately and Interventional radiology procedures without hospital admittance. • Endovenous laser therapy (EVLT) for • 24 percent of surgical ligation patients required overnight • Ankle-brachial index screening for peripheral arterial hospital stay, compared to none for embolization. disease (PAD) • No surgical incision in the scrotal area. • Angioplasty and stenting for PAD • As effective as surgery, as measured by improvement in Treatment • Prostate embolization for enlarged prostate semen analysis and pregnancy rate. Varicocele embolization is a nonsurgical, outpatient treat- • Uterine fibroid embolization • A patient with varicoceles on both sides can have them fixed ment performed by an ARA interventional radiologist • Varicocele embolization simultaneously through one vein puncture site compared to using imaging to guide catheters or other instruments inside • Chemoembolization surgery which requires two separate open incisions. the body. IV sedation and local anesthesia are used during • Chest port for IV access • No general anesthesia and no sutures. the approximately one-hour procedure to ensure that patients • And many more. are relaxed. Varicocele symptoms • Pain: Aching when an individual has been stand- During the procedure, an ARA interventional radiologist makes ing or sitting for long periods and pressure builds up on the To schedule an appointment, please call our a small nick in the skin at the groin using local anesthesia, affected veins. Typically, painful varicoceles are prominent in size. interventional case coordinators at (512) 467-9729. through which a thin catheter is passed into the femoral vein, • Fertility problems: There is an association between vari- directly to the . The physician then injects con- coceles and infertility. The incidence of varicocele increases trast dye to provide direct visualization of the veins so he/ to 30 percent in infertile couples. she can map out exactly where the problem is and where • Testicular atrophy: Shrinking of the testicles is another John W. Kish, M.D. to embolize (block) the vein. By placing embolization coils, the sign of varicoceles. Often, once the testicle is repaired it will ARA Interventional Radiologist ARA interventional radiologist blocks the blood flow in the return to normal size. vein which reduces pressure on the varicocele. By embolizing the vein, blood flow is redirected to other healthy pathways. Diagnosis • Typically, varicoceles appear on the left side of the scrotum. Open surgical ligation is the most common treatment for • Varicoceles look like a “bag of worms” by ultrasound or symptomatic varicoceles. Varicocele embolization, a non- venogram. surgical treatment performed by an interventional radiologist, • Abnormal blood flow can often be detected with a noninva- is a highly effective, widely available technique for treating sive imaging exam called color flow ultrasound or through a symptomatic varicoceles that is underutilized in this country. venogram – an X-ray in which a special dye is injected into the veins to highlight abnormalities.

*Society of Interventional Radiology

Embolization efficacy