Varicocele Embolization: Nonsurgical Treatment for Varicocele
What is a varicocele?
A varicocele is an enlargement of the veins within the scrotum, similar to a varicose vein, most often on the left side. It's a common issue among men, found on exam in roughly 4–11% of men, and up to 30% when checked with ultrasound. Varicoceles are the most frequent reversible cause of male infertility, with symptoms ranging from nothing at all to a dull, aching, or heavy sensation that worsens by the end of the day or with standing. It's often described as feeling like a "bag of worms."
Varicoceles can also affect sperm production and quality, which is why they're commonly evaluated as part of an infertility workup.
What is varicocele embolization?
Varicocele embolization is a well-established minimally invasive procedure to treat varicoceles. During this procedure, an interventional radiologist navigates a small catheter into the affected testicular vein via a small pin-hole incision in either the groin or the neck. Using live X-ray guidance, your interventional radiologist places coils or other embolic materials within the vein to close it off.
Immediately following embolization, blood from the testicle reroutes through healthy veins, pressure in the scrotum decreases, and the varicocele resolves.
What does the evidence show?
Varicocele embolization achieves technical success in roughly 90–98% of cases, with no significant risk of hydrocele or testicular atrophy.
For men being treated for infertility, studies show embolization is associated with meaningful improvement in sperm concentration, motility, and morphology by three to six months post-procedure.
Who is a candidate?
You may be a candidate for varicocele embolization if you:
• Have a symptomatic varicocele causing pain or discomfort.
• Have a varicocele contributing to abnormal semen parameters as part of an infertility evaluation.
• Have a varicocele you'd simply like treated without surgery.
Who is not a candidate?
It's not appropriate if you have:
• An active infection.
• An uncorrectable bleeding disorder.
What to Expect
Your treatment starts with a consultation with one of our interventional radiologists and a scrotal ultrasound (if you haven't already had one). The procedure itself takes about 60–90 minutes and is performed on an outpatient basis under local anesthesia with moderate (conscious) sedation. The procedure requires only a small puncture in the groin or neck with no surgical incision or general anesthesia.
Most men go home the same day and return to normal activity within one to two days. Mild testicular discomfort is common for up to a week or two and is managed with over-the-counter pain medication.