Varicocele embolisation

A varicocele is an enlargement of the veins surrounding the testicle, which results from abnormal (reversed) blood flow causing congestion (venous incompetence). Varicoceles are usually left sided, and can cause local swelling, pain and discomfort, and may be associated with infertility

Varicocele embolisation is a procedure in which the abnormal vein(s) are blocked, preventing blood flow from occurring in the wrong direction. Over time, this reduces congestion and causes the varicocele to disappear. When the abnormal veins are blocked, the testicles will continue to drain blood normally by other routes

Before the Procedure

Fasting: Do not eat or drink 4 hours prior to your procedure time

Allergies: Please tell Intra staff at the time of booking if you have any food or medication allergies, or previous reactions to X-ray contrast (dye).

Diabetes: If you are a diabetic, please tell Intra staff at the time of booking. You may need to discuss your insulin/diabetes medication doses with your radiologist.

Anticoagulants (blood thinner): If you are taking any blood thinners (e.g. Warfarin, Clexane, Pradaxa, Rivaroxaban), please make this known to Intra staff at the time of booking. Your interventional radiologist will advise you if you need to stop this medication temporarily for a few days before the procedure

Other regular medications: Continue taking these, unless otherwise discussed with your interventional radiologist.

During the Procedure

A varicocele embolisation procedure is performed by an interventional radiologist, and usually takes 30-60 minutes, depending on whether one, or two varicoceles are being treated. During the procedure you will be sedated but awake. Local anaesthetic will also be injected around the access site.

The right side of your neck is the easiest place to access the vein that leads to the varicocele. This area will be prepared with an antiseptic solution, and then sterile drapes will be placed around your face and the rest of your body to ensure sterility is maintained.

You will feel the local anaesthetic injection around the neck, which will sting for approximately 30 seconds, but after this, you should not feel any pain.

A small hollow tube (sheath) will be inserted into the vein in the neck. Using contrast dye and fluoroscopy, a catheter will be directed down into the abnormal veins close to the varicocele. Once the catheter is in an appropriate position, the sclerosant, or other embolisation agent, is injected into the vein to block it over a period of minutes.

Once the embolisation commences, you may feel a mild dull ache in the back or groin area. Please inform the interventional radiologist if you are uncomfortable, and pain relief will be given via your IV line.

After the Procedure and going home

You will be able to sit up straight away, but will remain on bedrest for 2 hours. The nurses will monitor your recovery and if appropriate, you will usually be discharged after 2 hours.

Someone must drive you home or accompany you in a taxi. Please arrange for accompanied transport in advance.

Due to the sedation, you may feel lethargic afterwards with reduced concentration. For this reason, for 24 hours after your procedure please:

  • Do not drive.
  • Do not drink alcohol.
  • Do not make any legal decisions or sign legal documents

Do not do any activity requiring strength, concentration, or full alertness for the rest of the day. • You can undertake light activities such as walking.

No heavy lifting or weight lifting (>5kg) for at least 5 days

What are the risks?

As with any procedure, there are potential risks involved. Your interventional radiologist will explain the procedure, discuss possible risks and answer any questions you may have. You will then be asked to sign the consent form. This will occur on the day of your procedure.