Varicocele Embolization in Cary, NC
What is a Varicocele?
Varicoceles are dilated veins located within the scrotum, which may cause discomfort, predominantly on the left side, particularly after prolonged standing, lifting heavy objects, or physical exertion. These veins transport an increased volume of blood compared to normal veins, resulting in elevated temperatures within the scrotum and affecting sperm viability. Elevated scrotal temperature can decrease sperm count, contributing to reversible male infertility.
Symptoms of Varicocele
The primary symptoms of varicoceles include pain and infertility. Pain typically starts as mild early in the morning and progressively worsens throughout the day with activities such as standing, sitting, and maintaining upright positions. Reduced sperm count associated with varicoceles can lead to infertility.
Causes and Diagnosis
Varicoceles arise from the reflux of blood in the gonadal vein, which is supposed to drain blood against gravity using valves designed to maintain upward flow from the pelvis. Malfunctioning valves result in reverse blood flow and pooling in the scrotum, causing vein enlargement and pain. The abnormal blood flow also raises scrotal temperature, inhibiting sperm production.
Diagnosis of varicoceles typically involves physical examination revealing enlarged veins resembling a “bag of worms,” ultrasound imaging to assess vein size and blood reflux, CT scans and MRI scans to visualize vein dilation, and decreased sperm count detected during infertility evaluations.
Treatment
Varicoceles can be treated via surgical intervention or embolization, which are equally effective. Embolization is performed in our office as an outpatient procedure without incisions or sutures. Under x-ray guidance, a catheter is navigated through the veins to the affected gonadal vein, where it is occluded using a liquid sclerosant and metal coils. This process induces vein scarring, redirecting blood flow and preventing pooling in the scrotum. The procedure generally takes less than an hour, is virtually painless, and patients are typically discharged within a few hours. Most patients achieve full recovery within 48 hours and experience complete pain relief within 4-6 weeks, alongside rapid recovery of sperm counts.
Benefits of varicocele embolization include:
- Minimal discomfort
- Short procedure duration (approximately one hour)
- Quick alleviation of painful symptoms
- Swift recovery period of 1-2 days
- No permanent scarring of the testicles
- Resumption of sexual activities within approximately one week, subject to individual medical advice
-
90% success rate, comparable to surgical options
