For men with varicoceles (varicose veins in the scrotum), there are two treatment options: varicocele ligation surgery or embolization. The surgical procedure involves an open incision above the scrotum, general anesthesia, and a lengthy recovery period, whereas embolization is a minimally invasive outpatient procedure that requires only a tiny cut in the skin, “twilight” sedation, and almost no downtime. Our endovascular physicians are experts when it comes to treating varicoceles without surgery.
During a varicocele embolization, a small tube is inserted into the femoral vein in the groin or a neck vein through a small nick in the skin (about the size of the lead in a pencil). The skin is numbed for this procedure and it is not painful.
Next, a small catheter or tube, is painlessly guided into the abdomen and into the varicocele vein under the guidance of X-ray imaging for accuracy. The vein is intentionally closed off by plugging it with small metals coils and a special medication (the same medication injected into leg varicose veins).
The embolization procedure takes 30 minutes and you will go home a few hours later with only a small bandage at the puncture site. You can immediately resume your non-exertional activities.
The advantages of varicocele embolization include:
- It is performed under local anesthesia with mild sedation (general anesthesia is used for varicocele surgery).
- It is performed on an outpatient basis in our office endovascular suite, not in a hospital.
- There is no surgical incision in the groin, only a tiny hole in the skin where a catheter is placed.
- A patient with varicoceles on both sides can have both fixed at the same time through one vein puncture site (surgery requires two separate incisions).
- It is as effective as surgery, as measured by improvement in pain, semen analysis, and pregnancy rates.
- There is a lower rate of complications compared to surgery; infection has not been reported after embolization.
