Varicoceles are relatively common, affecting an estimated 15% of men and higher among infertile men, up to 35% of whom may have varicocele, more common in males between the ages of 15 and 25.
Non-surgical varicocele treatment has gained significant attention as an effective and less invasive alternative to traditional surgical methods. It has been shown to improve fertility in some men and provide relief from the discomfort associated with varicocele, making it a preferred treatment option for many patients with a high success rate and relatively quick recovery, as varicocele treatment with coagulation is a modern solution to a condition that affects men’s health and quality of life.
What is varicocele embolization?
Varicocele embolization is a simple, non-surgical procedure designed to treat varicocele (enlarged veins in the scrotum that often affect male fertility and cause discomfort and pain). Varicoceles occur when the veins in the scrotum enlarge, similar to varicose veins in the legs. These veins are part of the plexus of seminal veins responsible for draining blood from the testicles.
When blood flow becomes ineffective, it can cause pain, testicular atrophy, and, in some cases, poor sperm production, leading to infertility.
Varicocele embolization involves sealing the enlarged veins and restoring normal blood flow, which relieves symptoms associated with varicocele. Unlike traditional surgery, it does not require large incisions or stitches, making it a popular treatment option for many men.
What is the mechanism of non-surgical varicocele treatment?
The primary mechanism behind varicocele embolization is to block the dilated veins that cause varicocele and redirect blood flow to healthy veins. This is accomplished through a catheter-based procedure performed by an interventional radiologist, who effectively blocks the abnormal veins, improving blood circulation in these veins and relieving symptoms. This is done in the following steps:
Catheterization
A small catheter, usually no larger than a pencil, is inserted into the femoral or jugular vein (neck area). The catheter is advanced through the blood vessels to the varicocele area under real-time X-ray guidance known as fluoroscopy.
Embolization
Once the catheter is placed in the affected veins, unique embolic materials such as coils, balloons, or sclerosing agents are inserted. These materials help block the veins responsible for varicocele. As a result, the blood flow through these veins is redirected to healthy veins, and the pressure on the vein that caused the pain and swelling is relieved.
Restoration of Blood Flow
Varicocele embolization restores normal venous drainage from the testicles by blocking the abnormal veins. This reduction in blood flow through the varicocele also helps to lower the high temperature around the testicles, which is thought to affect sperm production and fertility negatively. Varicocele embolization achieves the therapeutic effect by mechanically blocking the veins, restoring average blood circulation, and minimizing the harmful effects of varicocele.
How is varicocele treated with varicocele embolization?
Varicocele embolization is generally performed on an outpatient basis, which means the patient can go home the same day. The procedure is usually completed under local anesthesia, with central anesthesia available. Here is an overview of how varicocele embolization is performed:
- Preparation: Before the procedure, the patient may be asked to avoid eating or drinking for several hours. Upon arrival at the treatment center, the patient is positioned appropriately, usually lying on the X-ray table, and the skin over the groin or neck is cleaned and sterilized.
- Catheter insertion: A small incision of about 1-2 centimeters is made near the groin or neck, where the doctor inserts a thin, flexible catheter into the femoral vein or jugular vein (in the neck). The catheter is carefully threaded through the blood vessels to the site of the varicocele under the guidance of continuous imaging.
- Embolization procedure: Once the catheter reaches the varicocele, embolic agents are released into the veins. These substances work to block the abnormal veins. The choice of embolic agent depends on the varicocele’s specifics and the treating physician’s preferences.
- Completion: After the veins are plugged, the catheter is removed, and the small incision site is closed. The procedure takes 30 minutes to an hour, depending on the complexity of the case. Patients are generally monitored briefly and sent home the same day.
The role of embolization in improving blood flow and reducing pain
Varicocele embolization is effective through the following roles:
- Improved blood flow: Blockage redirects blood flow to healthy veins by blocking enlarged veins. This helps lower venous pressure in the scrotum, which reduces the congestion and discomfort caused by varicocele. Most importantly, improved blood flow also helps restore normal venous drainage from the testicles, which is critical to maintaining testicular health and function.
- Reduce pain: Pressure in a varicocele can cause significant discomfort and swelling, often making daily activities difficult.
- Improving fertility: Varicoceles are associated with infertility, as the high temperature and altered blood flow can impair sperm production and function. Varicocelectomy can help restore normal sperm function by improving blood circulation and lowering the elevated temperature around the testicles, boosting the fertility prospects of men who are infertile due to varicocele.
Advantages of varicocele embolization
Varicocele embolization offers several advantages over traditional surgical methods, making it a highly desirable option for many men seeking varicocele treatment:
- Less invasive: Catheter-based varicocele treatment requires only a small incision, unlike open surgery, which usually involves larger incisions.
- Shorter recovery time: Patients who undergo varicocele embolization typically have a much shorter recovery time than those who undergo surgical varicocelectomy. Most can return to light activities within 24-48 hours and resume normal activities within a week.
- Minimizes pain and complications: Since non-surgical varicocele treatment is less invasive than surgery, patients generally experience less pain and a lower risk of complications such as infection, bleeding, and scarring.
- It has a high success rate: Coagulation therapy is highly effective in treating varicocele with success rates similar to those of surgical varicocelectomy in relieving symptoms and improving fertility.
Recovery period after varicocele embolization
Recovery after varicocele embolization is relatively quick and uncomplicated; most patients can go home the same day, and the risk of complications is low. A typical recovery process includes the following:
- Rest for at least 24-48 hours after the procedure
- Use over-the-counter pain relievers to control any discomfort. Mild discomfort or bruising at the catheter insertion site is common, but these discomforts usually disappear within a few days.
- Schedule a follow-up appointment, usually in a few weeks, to monitor any symptoms’ recurrence and ensure the varicocele has been successfully treated.
Care tips after non-surgical varicocele treatment
To speed up the healing process and minimize the risk of complications, follow these care tips:
- Avoid heavy lifting or strenuous exercise for at least a week after surgery to avoid straining
- Monitor the incision site for signs of infection, such as redness, swelling, or increased pain, and call your doctor if these signs occur.
- Take prescribed medications as directed and control pain with over-the-counter medications if needed.
- Attend follow-up appointments to make sure the surgery was successful, and there are no complications.
Who is qualified to perform non-surgical varicocele treatment?
The non-surgical varicocele treatment procedure is suitable for most men with varicocele, especially those with pain, swelling, or infertility. This procedure is usually recommended for men:
- who are seeking fertility treatment.
- who want a less invasive option compared to traditional surgery
- who are not eligible for surgery due to other medical conditions or risks
Varicocele embolization may not be suitable for men with certain medical conditions such as clotting disorders or severe allergies to the materials used during the procedure.
Bimaristan Medical Center offers the latest techniques for treating varicocele without surgery in Turkey by coagulation, so do not hesitate to contact us and ask for a free consultation.
Varicocele embolization vs. Other surgical varicocele treatments
| Varicocelectomy | Varicocele embolization | |
| More invasive, requiring large incisions | Less invasive, no large incisions | Surgical intervention |
| General anesthesia | Local anesthesia | Anesthesia |
| Open surgery to remove or ligate veins | Inserting a small catheter | Method of procedure |
| Longer (1-2 weeks) | Short (24-48 hours) | Recovery period |
| Greater pain due to larger incisions | Minimal discomfort | Pain |
| Usually requires hospitalization | Same-day discharge from hospital | Discharge from the hospital |
| Higher risk of infection and scarring | Reduced risk of infection and scarring | Complications |
| less | Slightly higher | Risk of recurrence of varicocele |
For more information, you can read this article: Varicocele surgery for infertility
Possible risks and complications of varicocele embolization
Non-surgical varicocele treatment is a safe procedure, but rare complications may occur, such as:
- Infection at the catheter insertion site
- Blood pooling at the incision site
- Migration of occlusive material (the material used to block infected veins)
- Varicocele recurrence, which may require repeat treatment
- Allergic reactions to contrast dye or occlusive agents
Most of these risks can be minimized through careful planning of the procedure and aftercare.
Varicocele embolization is an effective, non-surgical treatment for varicoceles that offers significant benefits over traditional surgical methods. The treatment’s success rate, short recovery time, and low risk of complications make it a preferred option for many men with varicocele-related symptoms; however, it is important to discuss treatment options with your doctor to determine the most appropriate approach.
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