Treatments we provide
Varicocele Embolisation
Varicocele Treatment Options
Varicocele embolisation is a minimally invasive treatment option for men with a varicocele. A varicocele is an enlargement of the veins around the testicle caused by abnormal backward flow of blood. Not all varicoceles require treatment, but treatment may be considered when they cause pain, testicular changes or fertility concerns. Learn more about varicocele symptoms and diagnosis.
There are two main treatment options for a varicocele:
- Varicocele embolisation; or
- Surgery
Varicocele Embolisation
Varicocele embolisation is a minimally invasive, image-guided treatment for varicoceles. It works by blocking the abnormal testicular veins responsible for the varicocele, redirecting blood through healthy veins.
The procedure is performed by an interventional radiologist using ultrasound and X-ray guidance. A small catheter is inserted into a vein, usually through the arm, neck or groin, and guided to the abnormal testicular vein. The vein is then treated using coils and/or a sclerosing agent to stop the abnormal backward flow of blood.
Varicocele embolisation is generally performed as a day procedure under local anaesthetic with sedation. The procedure usually takes around one hour, and patients are discharged home the same day. Dr Ryan McConnell provides assessment and varicocele embolisation for patients in Sydney.
Varicocele Surgery
Traditional surgical varicocele repair is performed under general anaesthesia. An incision is made in the upper scrotum or groin and the veins are tied off to stop the back flow. Patients are usually able to go home the same day or the following morning. Usual return to work is 2-4 days. Small risks include infection and formation of a hydrocele.
Am I a Candidate for Varicocele Embolisation?
Not all varicoceles require treatment. Treatment may be considered when a varicocele is causing persistent pain or discomfort, is associated with reduced testicular size or function, or may be contributing to fertility problems.
Varicocele embolisation may also be considered in men with a recurrent varicocele following previous surgery, or in patients who would prefer a minimally invasive alternative to surgical treatment.
The most appropriate treatment depends on your symptoms, examination and imaging, as well as individual factors such as fertility concerns. Dr Ryan McConnell can assess your varicocele and discuss whether embolisation or another treatment option is appropriate for you.
Benefits and Risks of Varicocele Embolisation
Varicocele embolisation offers several potential benefits compared with surgical treatment, including:
- Minimally invasive treatment without a surgical incision
- Usually performed as a day procedure
- Relatively short recovery time
- Treatment can be performed on both sides during the same procedure when required
- It may be an option for recurrent varicocele following previous surgery
As with any medical procedure, varicocele embolisation has potential risks and complications. These are uncommon but may include:
- Bleeding, bruising or infection at the catheter insertion site
- Temporary discomfort following the procedure
- Allergic reaction to contrast material
- Migration of coils or other embolic material
- Failure to completely treat the varicocele or recurrence
- Rare complications related to the blood vessels or surrounding structures
Dr McConnell will discuss the expected benefits, alternatives and individual risks of treatment during your consultation.
Varicocele Embolisation Outcomes
Varicocele embolisation has a high technical success rate, although individual outcomes depend on factors including the anatomy of the abnormal veins and the reason for treatment.
For men undergoing treatment because of scrotal pain or discomfort, symptoms often improve following successful treatment, although complete resolution cannot be guaranteed.
In men with fertility concerns, treatment of a clinically significant varicocele may improve semen parameters in appropriately selected patients. Whether this results in improved fertility or pregnancy depends on multiple factors affecting both partners and should be considered as part of an overall fertility assessment.
Recurrence or persistence of a varicocele can occur after either embolisation or surgery. Further imaging and treatment may be considered if symptoms persist or the varicocele recurs.
Where will the embolisation be performed?
Dr Ryan McConnell performs varicocele embolisation at hospitals in Sydney, including Northern Beaches Hospital and the Mater Hospital. He is Head of Interventional Radiology at Northern Beaches Hospital and also holds a VMO appointment at Royal Prince Alfred Hospital.
The most appropriate hospital for your procedure will depend on your individual circumstances, private health insurance and hospital availability, and will be discussed with you during your consultation.
How do I prepare for my varicocele embolisation?
You will usually need to fast before your procedure. You will be given specific fasting instructions before your admission. Please let Dr McConnell know about all medications you take, particularly blood-thinning medications, as some may need to be adjusted before the procedure.
What is the recovery after varicocele embolisation?
Recovery after varicocele embolisation is usually relatively quick. Following the procedure, you will be monitored in hospital for several hours before being discharged home the same day. As sedation is usually used, you will need someone to take you home and you should not drive after the procedure.
Some mild discomfort, bruising or aching may occur following treatment and generally settles over the following days. Most patients can return to normal daily activities and work relatively quickly, depending on their occupation and how they feel.
You will be given specific instructions about exercise, heavy lifting and sexual activity following your procedure. These recommendations may vary depending on your individual circumstances and how the procedure was performed.
You will also be provided with contact details and instructions about symptoms that should prompt medical review after discharge.
What follow-up is required after varicocele embolisation?
Follow-up will be arranged after your varicocele embolisation to assess your recovery and response to treatment. The timing and type of follow-up will depend on the reason for treatment and your individual circumstances.
Further clinical assessment or testing may be recommended where appropriate, particularly for patients treated for persistent pain or fertility concerns.