What is Varicocele Embolization?
Varicoceles are abnormal enlargements of the veins in the scrotum. It is commonly found in adolescent boys in puberty, and occurs mostly around the left testicle, but can also occur on both sides. Varicoceles are generally harmless and don’t cause any pain; however, some boys may complain of heaviness in the scrotum, and when left untreated, the condition may cause stunted growth of the affected testes and infertility in adulthood. Varicocele embolization is a minimally invasive procedure that closes off blood flow to the affected vein(s), causing the varicocele to shrink and die off, without an operation.
Preparation for Varicocele Embolization
Pre-procedure preparation for varicocele embolization may involve the following steps:
- A written consent will be obtained from you seeking permission to do the procedure. You can clarify if you have any doubts about it.
- Your doctor may order tests such as ultrasound of your scrotum for detailed examination of the varicocele.
- You will be asked if you have allergies to any specific medications or contrast dye.
- You should inform your doctor of any medications, vitamins, or supplements that you are taking.
- You may be asked to refrain from certain supplements or medications for some days prior to the procedure.
- You may be asked not to eat or drink anything before the procedure.
- You may be instructed to shower with an antibacterial soap on the morning prior to the procedure to reduce the risk of infection.
- Arrange for someone to drive you home after the procedure.
How is Varicocele Embolization Performed?
- You will lie flat on your back on the procedure table.
- The interventional radiologist will administer sedatives and pain medicine intravenously to keep you comfortable throughout the procedure.
- A needle is inserted into your inner thigh to access a major vein and the radiologist meticulously inserts a catheter tube into this vein.
- This is followed by injection of contrast material into the vein via the catheter to check the abnormal veins.
- The radiologist can block the abnormal veins by injecting a special liquid or foam through the catheter. The fluid / foam is also known as a blocking agent and causes the vein to close down, and consequently block the vein. The catheter and special liquid will be left in place for up to 10 minutes to ensure the veins are blocked completely, and then the catheter is removed.
- After completion of the procedure, the site is covered with a bandage.
Post-procedure Care and Recovery from Varicocele Embolization
Varicocele embolization generally involves the following post-procedure care instructions:
- You will be transferred to the recovery area where your nurse will monitor your vital signs and observe you for any untoward effects.
- As it is an outpatient procedure, you will be discharged home on the same day once you are stable usually after 4 to 6 hours of observation.
- Most individuals are able to walk, eat, and drink within a couple of hours post procedure.
- You may experience some pain, swelling, and discomfort in the incision site. Pain and anti-inflammatory medications and cold packs are recommended as needed for comfort.
- Your physician may also provide you with antibiotics to prevent risk of infection.
- You should be able to resume all your normal activities within a few days.
- Refrain from strenuous activities and lifting heavy weights for the first few weeks as it may add pressure on the treatment area. Gradual increase in activities over a period of time is recommended.
- A periodic follow-up appointment will be scheduled to monitor your progress.
What are the Risks and Complications of Varicocele Embolization?
Varicocele embolization is a relatively safe procedure; however, as with any minimally invasive procedure, some risks and complications may occur, such as:
- Bruising at the entry site
- Mild backache, or nausea
- Hydrocele (collection of fluid in the testes)
- Infection
- Loss of testicles, exceedingly rare complication