Varicocele Q & A
A varicocele is an enlarged vein in a man’s scrotum that may cause pain, swelling or infertility. Varicocele embolization uses imaging guidance and a catheter to place a tiny coil and/or embolic fluid in a blood vessel to divert blood flow away from a varicocele. It’s less invasive than conventional surgery, can safely relieve pain and swelling, and may improve sperm quality.
Image-guided, minimally invasive procedures such as varicocele embolization are most often performed by a specially trained interventional radiologist in an interventional radiology suite. This procedure is often done on an outpatient basis.
How is the procedure performed?
You will be positioned on the examining table.
You may be connected to monitors that track your heart rate, blood pressure and pulse during the procedure.
A nurse or technologist will insert an intravenous (IV) line into a vein in your hand or arm so that sedative medication can be given intravenously. Moderate sedation may be used.
Your physician will numb the area, usually the groin, with a local anesthetic.
The area of your body where the catheter is to be inserted will be sterilized and covered with a surgical drape.
A very small skin incision is made at the site.
Using image-guidance, a catheter (a long, thin, hollow plastic tube) is inserted through the skin into the femoral vein, a large blood vessel in the groin, and maneuvered to the treatment site.
Small amounts of x-ray dye (contrast) are injected so that the interventional radiologist can clearly see the veins on the x-ray to pinpoint where the problem is and where to embolize, or block, the vein.
Tiny coils made of stainless steel or platinum or other materials, such as liquids, which directly close a vessel, are then inserted in the vein to block it. By blocking the diseased draining vein, backflow into the testicle is stopped and the blood is diverted to healthy veins to exit the testicle through normal pathways. Swelling and pressure within the testicle will be reduced if the blood flow is successfully diverted.
At the end of the procedure, the catheter will be removed, and pressure will be applied to stop any bleeding. The opening in the skin is then covered with a dressing. No sutures are needed.
This procedure is usually completed within one hour.
What will I experience during and after the procedure?
The interventional radiologist cleanses your skin above the insertion point for the catheter and applies a local anesthetic. Intravenous sedation is typically given so you will not experience much pain. Normally, you will not feel the catheter during the procedure.
Devices to monitor your heart rate and blood pressure will be attached to your body.
You will feel a slight pin prick when the needle is inserted into your vein for the intravenous line (IV) and when the local anesthetic is injected. Most of the sensation is at the skin incision site, which is numbed using local anesthetic. You may feel pressure when the catheter is inserted into the vein or artery.
If the procedure is done with sedation, the intravenous (IV) sedative will make you feel relaxed, sleepy and comfortable for the procedure. You may or may not remain awake, depending on how deeply you are sedated.
You may feel slight pressure when the catheter is inserted, but no serious discomfort.
As the contrast material passes through your body, you may experience a warm feeling which quickly subsides.
You will remain in the recovery room until you are completely awake and ready to return home.
You should be able to resume your normal activities within 24 hours.