Non Surgical Treatment of Varicocele : An Underutilized Safe Alternative
Veins contain one-way valves that work to allow blood to flow from the testes and scrotum back to the heart. When these valves do not work properly, the blood pools and enlarges the veins around the testicle in the scrotum to cause a varicocele to form. Performed by a urologist, open ligation is the most common treatment of varicoceles that cause symptoms for the patient. Varicocele embolization, a nonsurgical treatment performed by an interventional radiologist, is as effective as surgery with less risk involved, less pain and less time for recovery. Patients who are considering surgical treatment should also get a second opinion from an interventional radiologist to make sure they know all of their treatment options for varicoceles. You can always ask for a referral from your doctor, call the radiology department of your clinic and ask for an interventional radiologist or visit the doctor locator link at the top of this page to find a doctor near you.
How common is it ?
- About 10 percent of all men have varicoceles.
- Among infertile couples, 30 percent of men have varicoceles.
- The highest occurrence of varicoceles is in men ages 15–35.
- 80,000–100,000 men may undergo surgical correction of varicoceles each year.
Fertility problems: There is an association between varicoceles and infertility. Diminished sperm count, diminshed motility of sperm and a rise in the number of malformed sperm are related to varicoceles. Some doctors believe these blocked and swollen veins around the testes cause infertility by raising the temperature in the scrotum and decreasing the production of sperm.
Testicular atrophy: The shrinking of the testes is another sign of varicoceles. Many times the testes will return to its regular size once it is repaired.
Varicocele Diagnosis :
- Of the 95 percent of varicoceles that are found, they are located on the left side of the scrotum.
- The scrotum looks like a bag of worms.
- The testicles may be shrunken in size.
- On the off chance that varicoceles are not detectable through the above criteria, unusual blood flow can regularly be detected with a noninvasive imaging exam called color flow ultrasound or through a venogram—a radiograph in which a special dye is injected into the veins to “highlight” abnormalities of the blood vessels.
Varicocele : Treatment Options
Ayurvedic Varicocele Treatment
Homeopathic Varicocele Treatment
Catheter-directed embolization or varicocele embolization:
The interventional radiologist specifically makes a tiny incision in the skin at the groin using localized anesthesia, then a thin catheter (much like the size of spaghetti) is threaded into the femoral vein, directly to the testicular vein. The radiologist then injects contrast dye to give exact visualization of the veins to draw out exactly where the varicocele is and where to perform the varicocele embolization, or blocking of the vein. By using sclerosants or coils (injected medicine that goes into the blood vessels to shrink them), the interventional radiologist blocks the abnormal veins, thus reducing pressure on the varicocele. By doing the varicocele embolization, blood flow is directed to other pathways. Varicocele embolization essentially stops blood flow internally, therefore, accomplishing what the urologist does without a surgical procedure.
Advantages of Catheter-directed Embolization
- Cost effective
- No surgical incision in scrotal area
- No general anesthesia required
- No sutures
- No infections
- As effective as surgery, as measured by improvement in semen analysis and pregnancy rates
- Patients can return to normal daily activities immediately and without clinic admittance; surgery requires several weeks’ recovery and clinic admittance
- The rare patient who has varicoceles on both sides can have them fixed simultaneously through one vein puncture site; surgery on both sides requires two separate open incisions
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