Men’s Health Issues
What is a Varicocele?
Varicoceles are enlarged and tangled blood vessels in the scrotum. Similar to varicose veins in the legs, varicoceles are the result of abnormal “leaky” valves in the veins of the scrotum. These defective valves allow blood to flow the wrong direction resulting in pooling of the blood in the veins of the scrotum.
Varicoceles are relatively common occurring in approximately 10% of men. Varicoceles may cause no symptoms at all however, they can cause pain and in some circumstances, may actually cause other problems including testicular shrinkage and problems with fertility.
How are Varicoceles diagnosed?
Diagnosis begins with a clinical visit and physical exam. A painless and non-invasive testicular US may be ordered to actually visualize the enlarged, abnormal veins.
How are Varicoceles treated?
Varicoceles can be treated with surgical ligation or “embolization”. The surgical procedure requires a small open incision above the scrotum and is performed with general anesthesia. As with most surgical procedures, ligation is associated with relatively long down time and recovery.
A safer and more minimally invasive procedure involves embolization (intentional blockage) of the abnormal veins. The embolization procedure can be performed safely in our outpatient facility through a tiny skin nick with “twilight” sedation.
During the procedure, a small tube similar to an IV is placed in a vein in your groin or neck. A tiny catheter is then advanced into the varicocele using X-ray guidance. Tiny metal coils and a special medication are then introduced through the catheter and into the abnormal veins to block the flow of blood.
The procedure takes about 1 hour and you go home a few hours later. Because embolization does not require an open incision or general anesthesia, you are able to return to normal activities much quicker with minimal or no post procedure pain.
What are the advantages of embolization over surgery?
- Embolization is performed in our comfortable, state-of-the art outpatient endovascular facility, not the hospital
- Embolization can be performed with minimal “twilight” sedation rather than general anesthesia required for surgery
- Embolization is performed through a tiny poke in the whereas surgery requires an open incision in the groin. As a result, embolization is associated with minimal or no pain and requires almost no recovery
- Complication rates with embolization are lower than with surgery
- Embolization has been shown to be equally effective to surgery in decreasing pain, improving semen counts, and improving pregnancy rates