Varicocele is a medical condition that is characterized by the enlargement of veins within the spermatic cord, contained within the scrotum (the loose bag of skin that holds the testicles). Varicoceles are similar to the varicose veins found in the leg, and they can begin to form during puberty. They are usually found on the left side of the scrotum, but can also be present on both sides, though bilateral varicocele is much less common.

Varicocele may lead to male factor infertility because it can impair sperm production and decrease sperm quality and motility. Occasionally, varicoceles may cause pain or discomfort, though most varicoceles, particularly mild ones, do not interfere with fertility or cause discomfort. Aside from fertility, varicoceles can also interfere with the normal development of the testicles and even cause them to shrink (atrophy). Varicoceles can easily be diagnosed and most don’t require treatment. If the varicocele is associated with infertility and abnormal semen parameters, or produces symptoms, it is usually repaired surgically.

Treatment usually involves surgical procedures and medications are not commonly prescribed. Because varicocele can lead to infertility, it is important to start the treatment early in order for your sperm production to improve.

In most cases, varicoceles do not require treatment. However, if associated with pain and discomfort, infertility and/or testicular atrophy, you may want to consider surgical repair.

Since this condition can lead to fertility issues or adversely affect proper testicular functioning, the earlier the patient begins the treatment, the higher the chances of enhancing sperm quality. In some cases, supportive underwear or jockstrap can decrease discomfort associated with varicocele.

Right-sided varicoceles, or bilateral varicoceles, are uncommon and should be evaluated as they may be associated with other abnormalities.

How are Varicoceles Treated?

The preferred method of treatment is the nonsurgical Varicocele Embolization procedure. It is performed in our office-based, minimally invasive IR lab.

• The physician inserts a small catheter into a tiny incision in the groin area, accessing the femoral vein.
• Using x-ray, the physician then guides the catheter from the femoral vein, directly to the testicular vein
• Once in the testicular vein, contrast is injected in order to map out the problem area so it can be embolized – or “blocked” – using coils or particles.

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• Once the vein is blocked, the damaged vein is shut off and the blood flow is redirected to the surrounding, healthier veins.
• Pressure is eased on the varicocele, restoring normal function and eliminating pain.
• The patient is sent home shortly after the procedure and is back to normal activities the next day.

The whole procedure usually lasts about 30-45 minutes with a two hour recovery and the patient is back to moderate activity withing 24-48 hours.

Advantages of Interventional Urology Procedures

• Office based and minimally invasive
• Home in the same day
• Quicker recovery times
• Very low complication risks
• No general anesthesia needed
• Multi-disciplinary approach
• Ease of scheduling