A varicocele is a collection of swollen veins in the scrotum. It is a common condition, occurring in about 25% of young men, and usually causes only minor symptoms. In some men, however, a varicocele is associated with more severe pain which can be troublesome and interfere with normal activities. Varicoceles can also be associated with reduced fertility and are therefore commoner in those men suffering from fertility problems. Varicoceles occur because of a problem with the valves in the veins which carry blood from the scrotum and testicles. The condition, therefore, shares some similarities with varicose veins in the legs, and pelvic congestion syndrome in females.
- Aching or dragging sensation in the scrotum, groin or inner thigh
- Visible swollen veins
- Reduced fertility due to impaired sperm formation
- Testicular atrophy – a small testicle on one side
What causes a varicocele?
Similar to varicose veins, a varicocele is caused by abnormal vein valves. When leaky, these valves do not return blood back to the heart as they should and this causes a buildup of pressure and therefore swollen veins. They are commoner on the left side of the scrotum as the left testicular vein is more prone to valve problems.
How is a varicocele managed?
Many men do not need treatment for their varicocele. For those who have troublesome symptoms and in particular those with potential fertility issues, management options are as follows:
- Embolisation – where special thin metal coils are used to block the abnormal veins
- Surgery – where a cut in the groin or scrotum is used to close of the abnormal veins.
Undoubtedly symptoms are best managed by an individual patient-centred approach and some men would prefer surgery and others embolisation. When you are seen in rooms by the IR specialist you can trust that you will be only offered treatment if it is thought to be your best option.
- Email us and we will send you some information forms to complete
- Get your GP or specialist to refer you for a consult
After listening to your symptoms and taking a medical history we will discuss further investigations or scans needed to establish whether you are a candidate
This will be discussed at time of consult but may include:
- Ultrasound of the scrotum
If there are fertility problems then we will need a letter or copy of notes from the fertility specialist. Should varicocele embolisation be a suitable treatment option for you then further scans required may include
- MRI – if the pattern of varicocele is unusual or you have a more complex medical history
The treatment takes about 1 hour.
Unlike some other treatment options, varicocele embolisation is done using sedation and local anaesthetic. The procedure is not painful.
This procedure is performed by a specialist interventional radiologist – an expert in this area. Having the procedure performed by a specialist improves the effectiveness and reduces complications. A thin tube is introduced via a vein in the neck or groin and navigated to the veins inside the abdomen under x-ray guidance. Once in position special metal coils and sometimes foam are used to close the abnormal veins.
You will stay for a few hours only, until the sedation has fully worn off.
You will be able to return to work and other activities the next day. You will have to avoid exercise, heavy lifting etc for 5-7 days.
Embolisation is an excellent option if you are troubled by your varicocele but you do not want surgery. It does not involve any incisions or cuts on the groin or scrotum and does not need a general or spinal anaesthetic. Surgery risks damage to the tube which carries sperm from the testicle. Risks from embolisation are very rare but can include blockage of other normal blood vessels.
Embolisation is as effective as surgery but without the incision, scar or anaesthetic risks. Effects on pain and fertility are similar across both treatments.
No. Some men would prefer the surgical option but many men want to avoid an incision in the groin and do not want to risk damage to the tube carrying the sperm from the testicle.
A safe effective minimally invasive treatment option for men with symptoms or fertility problems as a result of their varicocele.