Varicoceles are abnormally dilated veins in the scrotum, often affecting young, otherwise healthy males with an incidence around 15%. They are usually left-sided with 10% seen bilaterally. They can be painful, cause testicular atrophy, and be associated with infertility. They are seen in about one-third of men being evaluated for infertility.
Diagnosis is usually made by the clinical exam and testicular ultrasound
- Open surgery performed by an urologist to occlude the vein
- Varicocele embolization
Varicocele embolization is a minimally invasive procedure performed by an interventional radiologist to occlude the abnormal scrotal veins. The procedure is performed as an outpatient under local anesthesia and IV sedation. A small catheter is placed in a peripheral vein and carefully guided into the abnormal scrotal vein under x-ray guidance. Through this tiny catheter, small coil plugs are inserted into the vein causing it to occlude. After vein occlusion, there is no longer abnormal reflux of blood into the scrotum. The catheter is subsequently removed and a small band-aid is applied at the catheter insertion site.
The procedure has a very high technical success rate. Patients go home the same day with minimal or no discomfort. Most patients resume their normal daily activities the following day.