TESTICULAR VEIN (VARICOCELE) EMBOLIZATION

What are the indications?

Varicocele is an enlargement of the veins in the scrotum (a bag containing your testicles). They usually develop slowly and only occasionally cause dull pain or pressure in the scrotum. If left unattended, they interfere with the sperm production, which may result in male infertility.

Embolization is an excellent alternative to surgical ligation. It does not involve general anesthesia, surgical incision or suture/scar in your groin or scrotum. You can go back to your active lifestyle in only a few days time.

Procedure

Before the intervention you will need ultrasound evaluation of your scrotum, which will confirm that the varicocele is the cause of your problems.

The procedure is done on an outpatient basis but is generally similar to general angiography and embolization.

The radiologist will, with a help of X-rays, place the tiny tube (angiographic catheter) into the vein draining your testicle and inject contrast to demonstrate anatomy of the veins and identify possible collaterals, which may be responsible for the recurrence.

The preferred agents are coils or sclerosing liquids. After administration, repeated injection of contrast will confirm that the testicular veins are completely blocked.

After removal of the catheter, you will be monitored in the X-ray department for 2-3 hours for the possible complications and discharged.

Is there any additional risk?

The possibility that the coils can dislodge into the venous system and be flown into your lungs is minimal. Even if it happens, you will probably not notice it, as the lungs vasculature capacity is big enough to compensate. Sometimes we may need to use vascular foreign body retrieval system to catch the loose coil. You will be advised to avoid any heavy physical activity for the 5-7 days in order to prevent late dislodgement.

Sometimes, the anatomy of the testicular veins and their branches may be too complex for the successful blockage. In that case the radiologist will advice you that the procedure is not technically feasible and your attending urologist will present you with the other (possibly surgical) treatment options.

Some patients complain of mild discomfort and pain at the back over the next 24-48 hours after the procedure, which rarely necessitates administration of painkillers.

The other risks are similar to general angiography and embolization

What are the chances of me becoming a father?

This will depend on different factors, but in your case mostly on duration of varicocele presence. It has been proven that pregnancy rates in infertile couples improve after varicocele repair by about 30-50%

 

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