What is a varicocele embolisation?
A varicocele is an abnormality of the veins that take blood away from the testicle. The veins become bigger and more obvious, rather like varicose veins in the leg. Embolisation is a way of blocking these veins, and therefore making them less obvious and causing the varicocele to disappear, without an operation.
Why do I need a varicocele embolisation?
Varicocele can cause various problems, including infertility. In the past, an open operation would have been necessary to get rid of the varicocele but now it can be treated by the technique of embolisation.
What happens during varicocele embolisation?
The procedure is performed by a Consultant interventional Radiologist under local anaesthetic.
A needle will be inserted into the large vein in the groin. Once correctly positioned, a guidewire is placed through the needle, and into the vein. Then, the needle is withdrawn allowing a fine plastic tube, called a catheter, to be placed over the wire and into the vein. The radiologist uses the x-ray equipment to make sure that the catheter and the guidewire are moved into the right position, into the varicocele, and then the wire is withdrawn. The radiologist can block the abnormal veins, either by injecting a special fluid down the catheter or by passing down small metal coils. These metal coils are like small spings, and cause the blood around them to clot and consequently block the vein. The radiologist will inject small amounts of a special dye, called contrast medium, down the catheter, to check that the abnormal veins are being blocked satisfactorily. Once they are blocked completely, the catheter will be removed.
Generally, the procedure itself will be over in about half an hour. You will generally stay in bed for a few hours, until you have recovered and then you will discharged the same day.
Will it hurt?
When the local anaesthetic is injected, it will sting to start with, but this soon passes off, and the skin and deeper tissues should then feel numb. After this, the procedure should not be painful.
Are there any risks or complications?
Varicocele embolisation is considered a very safe procedure, designed to prevent you from having a larger operation but there are some risks and complications that can arise. There may occasionally be a small bruise, called a haematoma, around the site where the needle has been inserted, and this is quite normal. Very rarely, some damage can be caused to the vein by the catheter, and this may need to be treated by surgery or another radiological procedure.
Unfortunately, there is always the possibility that although the varicocele seems to have been cured to start with, months or even years later, it may come back again. If this happens, then the procedure may need repeating, or you may be advised to have an operation. Despite these possible complications, the procedure is normally very safe, and is carried out with no significant side effects at all.
Author: Mr Francis Chinegwundoh MBBS FRCS MS FRCS(Urol) FEBU MML
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