Varicocele embolization is a technique that eliminates testicular varicose veins by selectively placing embolisms, or occlusions, designed to prevent the swollen veins from accumulating fluids. The blockage can be achieved using a special embolizing solution or an artificial metal such as stainless steel or platinum. The goal of any embolization procedure is to allow damaged or unwanted growths or vessels to atrophy, or to waste away. Varicocele embolization is a relatively new form of varicocele treatment for male patients. It is the first non-invasive form of varicocele repair. More traditionally, embolization has been used to treat fibroids, or benign growths, found in a woman’s womb.
Interventional radiologists perform embolization. Interventional radiology utilizes medical imaging technology to guide and then perform a series of minimally invasive medical procedures. Interventional radiology can treat a number of conditions that would typically need more invasive surgery to fix. Embolization for varicocele treatment enables patients to recover more quickly than they would be able to from types of varicocele surgery such as varicolectomy or laparoscopic varicocele surgery.
Varicoceles affect approximately 10 to 20 percent of male patients. Because varicoceles and infertility problems have been closely linked, many male patients having trouble conceiving may seek out varicocele treatment as a way to improve their sperm production. Pooled blood inside the scrotum can reduce sperm quality and sperm count for those with testicular varicose veins. Varicocele embolization is a great option for patients who hesitate to undergo invasive varicocele surgery to tie off their damaged veins.
There is a group of vessels and ducts called the spermatic cord within the male reproductive organs. The purpose of the spermatic cord is to drain various fluids into the testes. When blood valves in the veins of the spermatic cord are not working properly, fluid levels can become unbalanced and can affect that patient’s ability to produce good sperm. Improper drainage of blood and lymphatic fluid into the testes can also cause pain and swelling that sometimes cause testicular varicose veins to protrude from the skin unattractively.
During a varicocele embolization procedure, a doctor intentionally introduces small blockages called embolisms into the swelling veins of the scrotum. The veins are injected with a dye solution and then the emboli are placed using a small catheter guided by an x-ray machine. Purposefully introducing an embolism into the body may seem counter-intuitive, since blockages in the blood vessels are typically thought of as a threat to health. However, blocking flow into an already swollen varicocele will cause the vein that had been causing the varicocele to eventually die away.
Patients undergoing varicocele embolization are sedated and anesthetized during the procedure. The groin is shaved and cleaned prior to the embolization. The catheter is then inserted through a very small point of entry above where the embolism is to be placed. The interventional radiologist then maneuvers the catheter into the vein leading to varicoceles by using an x-ray machine and dye injections. At that point, an embolism is inserted into the vein in order to block it. The targeted vein will then atrophy, or fade, as blood flow naturally reroutes toward healthier, unblocked veins.
Near the end of the varicocele embolization procedure, the catheter is removed and the point of entry is covered with a special dressing to prevent bleeding. No stitches are necessary. The entire embolization procedure takes about 1 hour. The procedure carries less risk than a traditional varicocelectomy, but there is a higher chance that testicular varicose veins will reappear. If you are suffering from varicoceles or if you have questions about a varicocele and infertility, contact a vein center with doctors who can assist you.