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Varicocele Embolization

Last updated April 8, 2018

Varicocele Embolization involves putting a tiny coil or embolization material in the blood vessel to divert the blood from a varicocele.


Background Information:

What are the other Names for the Procedure?

  • Male Infertility Treatment
  • Percutaneous Varicocele Embolization

What is Varicocele Embolization radiology procedure (General Explanation)

  • Varicocele Embolization involves putting a tiny coil or embolization material in the blood vessel to divert the blood from a varicocele
  • A varicocele is caused by an enlarged vein in the male scrotum. The condition causes swelling, pain, and infertility. A diagnosis of this condition is usually done by a clinical examination and ultrasound, which is also done to examine the varicocele further

What part of the Body does the Procedure involve?

The Varicocele Embolization procedure involves the male scrotum.

Why is the Varicocele Embolization radiology procedure Performed?

Varicocele Embolization is performed to relieve the symptoms of varicocele, such as pain, swelling, and improvement in sperm quality, to treat infertility.

What is the Equipment used? (Description of Equipment)

The following equipment is used for Varicocele Embolization:

  • Fluoroscopy:
    • Fluoroscopy uses X-ray technology to produce images in real-time
    • Fluoroscopy consists of an examination table, an x-ray tube, and a television-like monitor
    • The images produced by fluoroscopy can be seen on the monitor, while the procedure is being carried out            
  • Catheter: It is a long, thin plastic tube that is used to put embolizing material in the varicocele
  • Embolization material

What are the Recent Advances in the Procedure?

There have been no recent advances in the Varicocele Embolization procedure.

What is the Cost of performing the Varicocele Embolization radiology procedure?

The cost of Varicocele Embolization procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

  • It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding Varicocele Embolization procedure and what needs to be done
  • If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
  • Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

http://www.ncbi.nlm.nih.gov/pubmed/25523457 (assessed on 3/9/15)

http://www.ncbi.nlm.nih.gov/pubmed/25458620 (assessed on 3/9/15)

http://www.ncbi.nlm.nih.gov/pubmed/25394405 (assessed on 3/9/15)

Prior to Varicocele Embolization radiology procedure:

How does the Varicocele Embolization radiology procedure work?

  • A varicocele forms due to an enlarged vein in the scrotum. The condition causes swelling, pain, and infertility
  • Varicocele Embolization involves putting a tiny coil or embolization material in the blood vessel to divert blood from the varicocele. In doing so, blood is diverted from the varicocele toward healthy veins, which can drain blood from the testes effectively

How is the Varicocele Embolization radiology procedure Performed?

The Varicocele Embolization procedure is performed in the following manner:

  • The patient is positioned in a supine position on the examination table
  • Vital signs, such as blood pressure, pulse, and heart rate, are monitored using various devices
  • An IV line is inserted into the patient’s arm vein, which is used for giving IV fluids and sedation
  • The catheter insertion area is cleaned, shaved, sterilized, and surgically draped. A local anesthetic is used to numb the catheter insertion area and a small skin incision is made for catheter insertion
  • The catheter is inserted under fluoroscopic guidance and advanced into the femoral vein, which is located in the groin. The catheter is advanced in the femoral vein to the treatment site
  • A contrast dye is injected to see the veins and confirm location of the varicocele
  • An embolizing material is injected into the treatment vein to block it. Thus, blood is diverted to healthy veins which drain blood from the testicles effectively
  • After the procedure is completed, the catheter is removed and pressure is applied to prevent the bleeding
  • No sutures are necessary since the skin incision is very small. The patient is taken to the recovery area after the procedure is complete

Where is the Procedure Performed?

Varicocele Embolization procedure is performed as an outpatient procedure, at a hospital.

Who Performs the Procedure?

An interventional radiologist performs the Varicocele Embolization procedure.

How long will the Procedure take?

  • The Varicocele Embolization procedure takes about an hour to complete
  • It may take longer depending upon the complexity of the anatomy and health of the patient

Who interprets the Result?

An interventional radiologist interprets the results of the Varicocele Embolization procedure.

What Preparations are needed, prior to the Procedure?

Following preparations are needed prior to a Varicocele Embolization procedure:

  • Patients should inform their physicians about their medical conditions, medications, and any over the counter medications, or herbal supplements that they are taking
  • Patient should inform their physician if they are allergic to any medications, especially to local anesthetic medications, contrast material, and general anesthesia
  • Patients may be asked to stop taking blood thinner medications such as NSAIDs, aspirin, heparin, or warfarin
  • Patient may be asked not to eat or drink anything a few hours before the procedure

What is the Consent Process before the Procedure?

A physician will request your consent for Varicocele Embolization procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent. 

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of Varicocele Embolization:

  • It is a minimally invasive procedure with a very short recovery period
  • Success rate with the procedure is as good as when performed using more invasive surgical procedures

Following are the risks of Varicocele Embolization:

  • Since catheter is placed in the vein, there is a risk of damaging the vein and causing bleeding
  • Embolic agent used during the procedure may lodge at the wrong location and stop blood supply to the normal tissues
  • Complications associated with embolization include phlebitis, epididymitis (inflammation within the scrotum), and lower back pain
  • The skin incision made for catheter insertion may get infected
  • Contrast material used during the procedure may cause severe allergic reaction in some cases

What are the Limitations of the Varicocele Embolization radiology procedure?

Following are limitations of Varicocele Embolization:

  • Recurrence of varicocele after Varicocele Embolization in a very small patient population group
  • In small number of patients, it is not possible to position the catheter correctly to treat the varicocele. In such cases, a surgical intervention may be necessary

What are some Questions for your Physician?

Some of the basic questions that you might ask your healthcare provider or physician are as follows:

  • What is a Varicocele Embolization procedure?
  • Why is this procedure necessary? How will it help?
  • How soon should I get it done? Is it an emergency?
  • Who are the medical personnel involved in this procedure?
  • Where is the procedure performed?
  • What are the risks while performing the procedure?
  • What are the complications that might take place during recovery?
  • What are the possible side effects from the procedure? How can I minimize these side effects?
  • How long will it take to recover? When can I resume normal work?
  • How many such procedures have you (the physician) performed?
  • Are there any lifestyle restrictions or modifications required after the procedure is performed?
  • Are there any follow-up tests, periodic visits to the healthcare facility required after the procedure?
  • Is there any medication that needs to be taken for life after the procedure?
  • What are the costs involved?

During the Varicocele Embolization radiology Procedure:

What is to be expected during the Varicocele Embolization radiology procedure?

The following may be expected during the Varicocele Embolization procedure:

  • Patient may feel a slight pinprick when the IV line is inserted. The catheter insertion site is numbed using a local anesthetic
  • When the catheter is inserted, patients may feel a slight pressure and discomfort
  • If IV sedation is used, patient may feel sleepy and relaxed
  • Patient may feel a warm sensation when the contrast material is injected during the procedure
  • After the procedure, the patients are taken to the recovery room

What kind of Anesthesia is given, during the Procedure?

Moderate sedation or general anesthetic is used during the Varicocele Embolization procedure.

How much Blood will you lose, during the Procedure?

Since it is a minimally invasive procedure, the blood loss involved during the procedure is minimal.

What are the possible Risks and Complications during the Varicocele Embolization radiology procedure?

Following are the possible risks during the Varicocele Embolization procedure:

  • There is a risk of damaging the vein and causing bleeding during the catheter placement
  • Embolic agents may get lodged at the wrong location and stop blood supply to normal healthy tissues
  • Some of the complications of the procedure include inflammation of the scrotum, of the vein walls, and lower back pain
  • An infection may arise from the skin incision made during the catheter insertion
  • In some individuals, the contrast material used during the procedure can cause severe allergic reactions

What Post-Operative Care is needed at the Healthcare Facility after the Varicocele Embolization radiology procedure?

No specific post-operative care is needed at healthcare facility after the Varicocele Embolization procedure.

After the Varicocele Embolization radiology procedure:

What is to be expected after the Varicocele Embolization radiology procedure?

  • The patients are taken to the recovery room after the Varicocele Embolization procedure and kept there, until they are completely awake
  • The physician will advise on patient discharge based on each individual’s health parameters
  • Generally, patients may resume their normal activities 24 hours after the procedure

When do you need to call your Physician?

Patients may need to call their physician in the following situations after a Varicocele Embolization procedure:

  • If the patient experiences severe pain in the scrotum
  • Any signs of infection are noted at the catheter insertion site such as redness, warmth, pain, or swelling accompanied by fever or chills
  • If the patient experiences severe lower back pain

What Post-Operative Care is needed at Home after the Varicocele Embolization radiology procedure?

There is no specific postoperative care required at home after the Varicocele Embolization procedure. The patients may resume their normal activities in 1-2 days

How long does it normally take to fully recover, from the Procedure?

It may take about 24 hours to fully recover from the Varicocele Embolization procedure. Normal activities may be resumed after this recovery period.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

Varicocele Embolization procedure does not involve the removal of any body tissue.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the Varicocele Embolization radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

  • The hospital, where the procedure is performed
  • Healthcare providers, physicians, and radiologists, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before the Varicocele Embolization procedure is performed.

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: March 24, 2015
Last updated: April 8, 2018