Varicocele embolisation

What is a varicocele embolisation?

A varicocele occurs when the veins can’t take the blood away from the testicles normally. The veins become bigger and more obvious, similar to varicose veins in the leg. Embolisation is a way of treating these veins, which causes the varicocele to disappear in most cases.

Risk and benefits

This procedure can treat the varicocele and can help improve fertility. Varicocele embolisation is a safe procedure—it is alternative to surgery and allows a quicker recovery. You may get a small bruise around the needle entry site, usually in the neck. Occasionally there is some discomfort following embolisation and very rarely the pain is significant.

We usually use coils to block the vein which are permanent. Very rarely a coil might move during the procedure, in which case it can be removed immediately. Embolisation is nearly always successful in treating the varicocele, but it can come back again, months or even years later. If this happens, the procedure may need repeating or you may be advised to have an operation. We will discuss all of the risks and benefits with you in detail before your procedure.

What happens on the day of my procedure?

Eat and drink normally up to 4 hours before your appointment time. After this, do not eat or drink until after the procedure. This is in case we need to give you medication to make you relaxed, in which case you should not drive home. Bring a snack with you to eat after your procedure.

Please take all your usual medication (except aspirin, clopidogrel, warfarin, other blood thinners or metformin). If you are diabetic, take your regular insulin—we will monitor you blood sugar. If you use inhalers or GTN spray, bring them with you.

Please attend, as directed on your appointment letter, in sufficient time for your appointment.

What happens before the procedure?

A nurse will ask you several questions about your health and current medication. They will take your blood pressure and pulse and ask you to change into a gown. You will then be transferred to the radiology department. You will be seen by the radiologist to discuss the procedure before you sign a consent form.

Please ask any questions you may have as it is important that you understand what is going to happen.

During the procedure

In the procedure room you will lie on a special X-ray table. Your neck or groin will be cleaned with antiseptic fluid and you will be covered with a sterile sheet. You will be given local anaesthetic. This stings initially and then the skin is goes numb.

Throughout the procedure your blood pressure and pulse will be monitored. Please inform us if you feel any discomfort. The doctor will insert a fine plastic tube (catheter) into the vein in your neck or groin, and then use X rays to guide the catheter into the abnormal vein. The doctor will inject dye and take X-ray pictures.

Once the catheter is in the correct position, small metal coils (like small springs) will be placed into the vein feeding the varicocele, sometimes together with a “foam” sclerosant, which helps to permanently close the vein—a nurse may press on your groin at this point.

Your body will naturally continue to supply blood to your testicle, and healthy veins will take over from the treated abnormal vein. The procedure usually takes about an hour but may take longer.

After the procedure

We will record your pulse and blood pressure as well as check the needle entry site. If you feel unwell at any time, please tell us.

Once we are satisfied that you have recovered after your procedure you will be able to get changed and go home. This will be about one hour after your procedure.

Things to avoid

• You should avoid driving on the day of your discharge.
• Avoid sport, excessive activity or lifting anything heavier than 5 kg (11 lb) for the next 2–3 days.
• Only shower for 3–4 days or until the skin site is healed.
• For pain or discomfort, take pain-relieving medications such as paracetamol and ibuprofen.

If the needle entry site becomes red, warm or tender, or if you develop a fever in the next few days after your procedure, please see your GP or go to your local A&E.

Contact information

Interventional Radiology Department
Chelsea and Westminster Hospital
369 Fulham Road
London
SW10 9NH
T: 020 3315 8570/8582