Varicocele
Embolisation

Learn more
What is a varicocele?

A varicocele is the medical term for an abnormal network of veins in the scrotum around the testicle. Varicoceles can occur on the left, right, or both sides.

 

They affect around 15 in every 100 men. Normally, blood flows into the testicles via the testicular artery and drains out through the testicular veins. One-way valves in these veins should prevent blood flowing backwards. If the valves fail or are absent, blood pools in the veins, forming a varicocele. Varicoceles are more noticeable when standing, as gravity increases the pooling of blood.

Most varicoceles cause no symptoms, but some men may experience aching or discomfort in the scrotum. They can occasionally be linked with male infertility.

What is a varicocele embolisation?

Embolisation is a specialised, non-surgical method to treat varicoceles, which are causing discomfort or infertility. It is permanent and uses either special metal coils or foam to block the abnormal testicular vein(s). The normal veins are preserved.

 

Embolisation is performed in a special operating theatre in the Interventional Radiology (IR) Department. It is a day case procedure, so you only need to spend a few hours in hospital. If you have two varicoceles or infertility, both sides will be treated at the same time. Otherwise, just the affected side is treated.

 

Varicocele embolisation is performed via a small cut in either the neck or the groin. A special wire and tube is then steered inside the testicular veins using X-rays to guide the interventional radiologist. This allows targeted treatment of the abnormal vein from within the vein itself.

Important information
Before your procedure
  • You will have blood tests beforehand.
  • Please bring a full list of your medications (including tablets, inhalers, and creams).
  • Some medicines may need to be stopped before the procedure. Your IR doctor or nurse will advise and let you know when to restart them.
  • If your ultrasound or CT scans are not recent, new scans may be needed. These can be arranged by contacting Dr Nimit Goyal.
  • Do not eat or drink (except water) for six hours beforehand. You may drink water until two hours before.
  • Arrive 45 minutes before your appointment for preparation. You will change into a hospital gown and your doctor will review your medications.
  • You will be asked to sign a consent form after discussing risks, benefits, and alternatives.
  • A friend or family member (maximum of two) should accompany you. You will need someone to take you home and stay with you for 24 hours.
  • The procedure is usually performed under local anaesthetic (you will be awake). You may feel slight discomfort at the access site, but stronger pain relief can be given if needed.
  • You will lie on your back. Nurses will monitor your blood pressure and pulse throughout.
  • The access site (neck or groin) is cleaned and numbed. A catheter is then guided into the testicular vein using X-ray. Small metal coils are placed to block the abnormal vein.
  • Once complete, the catheter is removed and gentle pressure applied to prevent bleeding. A small dressing is used – no stitches are required.
  • The procedure usually takes 40-60 minutes, longer if both sides are treated.
  • You will rest in the IR Department for 3-4 hours while checks are made.
  • You can usually go home the same day with an escort. Avoid public transport in case you feel unwell.
  • Do not drive for 24 hours and avoid heavy lifting or strenuous exercise for 48 hours.
  • Mild discomfort may occur but is usually managed with simple painkillers such as paracetamol.
  • Minimally invasive – no incision into the scrotum
  • As effective as surgery for improving pain and semen quality
  • Both sides can be treated through a single puncture site
  • No general anaesthetic required
  • Day case procedure with faster recovery (1-2 days)
  • Lower complication rate compared with surgery

Although safe and controlled, possible risks include:

  • minor bruising at the access site (groin or neck)
  • mild aching in the groin or lower back for a few days
  • damage to the testicle if too many veins are blocked (rare)
  • accidental migration of a coil or foam into another vein, usually recognised immediately and corrected during the procedure

We want you to be fully involved in decisions about your care. If you choose to go ahead, you will be asked to sign a consent form confirming that you understand the risks, benefits, and alternatives. You will have the chance to ask any questions.

  • No surgical incision or stitches
  • As effective as surgery
  • Day case procedure with no overnight stay
  • Quick recovery (1-2 days)
  • Fewer complications
  • Both sides can be treated at the same time