Varicocele embolization in men
The procedure is also known as the devascularization of the dilated veins in the scrotum.
Why would you need the intervention?
Dilated veins in the scrotum around the testes (varicocele) are caused by a disease of testicular vein junctions and valves causing blood to return and remain around the testis while significantly dilating the veins. A patient starts experiencing symptoms when the veins in the scrotum reach a high degree of dilatation, causing an increased testicular heat. The “bag of worms” structures (dilated veins) are usually palpable around the testes. Other symptoms include pains, discomforts, itching and increased sweating of the scrotal skin. Men with varicocele usually have fertility problems and a poor spermiogram result. All previously described problems indicate the intervention. Alternatively, a varicocele could be treated by the urological varicocele ligation procedure.
When would you need the intervention?
Embolization is indicated in male patients diagnosed with the dilation of the scrotal veins (varicocele), verified by a color flow Doppler ultrasound examination of the scrotum and testis or abdominal and pelvic MRI venography, and in patients who have clear symptoms e.g. discomforts, pains, itching, increased sweating of the scrotal skin or infertility problems with a poor spermiogram result.
Which radiological examination is required before indicating an intervention?
Ultrasound and Color flow Doppler of the scrotum
Magnetic resonance – Abdominal and pelvic MRI venography
What does the intervention include?
Testicular vein embolization is performed in local anesthesia and a patient is sedated. The intervention starts with a small needle stick in the inguinal vein. A thin catheter is threaded to the targeted dilated testicular vein. Various embolization materials are applied to achieve blockage of the blood flow in order to exclude the vein from the venous circulation. The intervention is performed though one insertion. All dilated testicular veins are embolized. The duration of the intervention is usually around 60-90 minutes. The intervention ends by pressuring the catheter insertion site with hands or by using an additional agent to close the insertion site.
Should a patient expect some discomforts during and after the intervention?
The only discomfort is usually a mild pain or discomfort in the abdomen and scrotum during a few days after the intervention. A slightly higher body temperature occurs very rarely.
A patient can return to his daily routing 24 to 48 hours after the embolization performed.
What result should a patient expect from the intervention?
After the testicular vein embolization, a patient can expect a relief of the symptoms and improvement of the spermiogram result.
How to get prepared?
A patient is to come on an empty stomach and shall not smoke before the intervention (at least for 6 hours). A patient should have his groins shaved.
Related tests and examinations:
A patient should bring laboratory test results (creatinine blood and prothrombin time are obligatory).