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A varicocele is an abnormality of the veins that take blood away from the testicle. A series of one way valves in the vein prevent the reverse flow of blood back to the testicles. These one way valves sometimes fail, and the reverse flow of blood stretches and enlarges the tiny veins around the testicle which causes a varicocele. These are similar to varicose veins in the leg.
Sometimes varicoceles cause no symptoms and are harmless. Occasionally, varicoceles can cause discomfort in the scrotum, aching pain, or infertility.
This is a procedure to treat varicoceles. It is a sterile procedure performed under x-ray guidance, in which the vein draining your testicle is blocked with a number of small metallic coils. The procedure is done as a day case in the Interventional Radiology (IR) department. This means you will come to the hospital, have your procedure and will return home a few hours later, on the same day.
Varicoceles can cause problems, including pain and infertility. In the past, an open operation would have been necessary to treat the varicocele but now it can be treated by the technique of embolisation.
The doctors, generally the Urologist in charge of your case and the Interventional Radiologist (the doctor who specialises in Imaging procedures) will have discussed your case and recommend this as the next step. However, if after discussion you do not want the procedure then you can decide against it.
A specialist doctor called an Interventional Radiologist. Radiologists are experts in using X-ray equipment and in microsurgical techniques.
In the Imaging Department, in a special Interventional Radiology (IR) Procedure Room which is designed for these specialised procedures. You will be checked into the department by a nurse, who will ask some medical questions and fill out some paperwork. The Interventional Radiologist will then come and talk to you about the procedure, and you will have the opportunity to ask any questions or raise any concerns. Only if you are happy to continue with the procedure will you be asked to sign the consent form.
It is performed in the IR procedure room. You will lie on a special x-ray table on your back and be covered with sterile drapes.
In a few cases the radiologist can’t get to the relevant vein. If this happens the radiologist will not be able to proceed and will need to consider an alternative for a later date which they will discuss with you.
To prepare for the procedure you will need to make sure you do the following:
Please let us know if you are taking any antiplatelet medicines (for example, Aspirin, Clopidogrel) or any medicines that thin the blood (for example, Warfarin), as these may need to be withheld temporarily before the procedure. Call the IR department for advice as soon as you get your appointment letter on 01273 696955 Extension 4240/4278 and ask to speak to one of the IR nursing team.
If you are taking medicines for diabetes (for example metformin) or using insulin, then these may need to be altered around the time of the procedure. Call the IR department on the numbers above for advice as soon as you get your appointment letter.
You cannot eat or drink anything (except water) for four hours before your procedure. You can drink water up to two hours before your procedure.
You will need a responsible adult to take you home.
When the local anaesthetic is injected it will sting for a moment but the stinging will wear off leaving the area of skin numb. After this the procedure should not be painful however if you feel discomfort there will be a nurse with you who will be able to arrange for further anaesthetic or sedation, if it is required. After the contrast medium (x-ray dye) is injected you will get a warm sensation in your pelvic area.
Whilst every patient and every patient’s situation is different we allow an hour for the procedure.
You will be required to recover in our recovery area either on a trolley or chair and will stay in the department for 1-2 hours after the procedure. The nurses will carry out routine observations, blood pressure, pulse and monitoring of the skin entry point, to ensure there is no bleeding.
Please arrange for someone to pick you up and take you home and remain with you for 24 hours following the procedure, as you must not drive or use public transport or be at home alone.
Despite the possible complications the procedure is normally very safe. However, the following side effects may occur:
There is always the possibility that although the varicocele seems to have been cured, months or even years later it may reoccur. If this happens then the procedure may need repeating or you may be advised to have an operation.The Radiologist will discuss all risks with you before the procedure and you can decide if you want to proceed during then.
Typically, patients are observed for a couple of hours either on a stretcher or in a chair and go home the same day.
If you feel you need urgent medical attention or are worried about anything please contact the IR department Monday - Friday 9am - 5pm, your GP, or go to your nearest A&E department.
Some of your questions should have been answered by this leaflet but remember that this is only a starting point for discussion about your treatment with the team looking after you.
Make sure you are satisfied that you have received enough information about the procedure before you sign the consent form.
Interventional Radiology: 01273 696955 Extension: 4240/4278.
This information is intended for patients receiving care in Brighton & Hove or Haywards Heath.
The information here is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.
Review Date: February 2023