Minimally invasive treatment
Varicocele embolisation: treatment without surgery
Varicocele embolisation is a minimally invasive treatment for enlarged veins around a testicle. Using a thin catheter, an interventional radiologist blocks the abnormal vein so blood is redirected through healthier pathways. This can reduce the pressure that contributes to a varicocele. It may be considered when a varicocele causes persistent discomfort or is relevant to a fertility assessment. The procedure uses a small skin puncture rather than a scrotal incision. Dr Ryan McConnell assesses your symptoms and investigations to determine whether embolisation is suitable for you.A GP referral is needed to book. Phone (02) 9023 9970.
The procedure
The procedure is usually performed under local anaesthetic with mild sedation. A small catheter is inserted into a vein in the neck, groin or arm. Dr McConnell guides it towards the vein draining the varicocele using live X-ray images. Contrast dye helps show the position of the veins and the direction of blood flow. Once the abnormal pathway has been identified, coils, a liquid embolic agent or both are used to close it. The catheter is removed at the end of the procedure, and a small dressing is placed over the entry site.
How is varicocele embolisation performed?
The procedure is usually performed under local anaesthetic with mild sedation. A small catheter is inserted into a vein in the neck, groin or arm. Dr McConnell guides it towards the vein draining the varicocele using live X-ray images. Contrast dye helps show the position of the veins and the direction of blood flow. Once the abnormal pathway has been identified, coils, a liquid embolic agent or both are used to close it. The catheter is removed at the end of the procedure, and a small dressing is placed over the entry site.
X-ray after left varicocele embolisation. The small metal coils block the faulty vein.
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Venous access
After local anaesthetic, a small tube is placed in a vein in the neck, groin or arm.
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Catheter guidance
Using live X-ray images, Dr McConnell guides a thin catheter to the vein draining the varicocele.
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Embolisation
Coils, a liquid embolic agent or both are used to close the abnormal vein.Who may be suitable for varicocele embolisation?
Embolisation may be considered when a varicocele is causing ongoing pain or discomfort, when there are fertility concerns with an abnormal semen analysis, or when a previous surgical repair has not been successful. It may also be considered when you would prefer to avoid surgery. Whether treatment is appropriate depends on your symptoms, examination findings and investigations. A consultation with Dr McConnell can help determine whether embolisation is suitable in your situation.
Potential benefits of varicocele embolisation
Varicocele embolisation avoids a surgical incision in the scrotum and is performed through a small venous puncture. Most patients return home the same day.- Small venous puncture: Treatment is performed through a small access site rather than a scrotal surgical incision.
- Same-day discharge: Most patients return home on the day of the procedure.
- Relatively short recovery: Many people return to desk work within one to two days. Physical work may need more time.
How does recovery differ?
Varicocele embolisation compared with surgery
Varicocele Embolisation
Performed through a small venous puncture rather than a surgical incision.- Home: Most patients return home the same day.
- Light activity: Usually within a few days.
- Work: Often within one to two days for desk work. Physical work may need more time.
- Strenuous exercise: Usually avoided for approximately one week.
Surgical Repair
Performed through a surgical incision to identify and divide the affected veins.- Home: Often the same day, depending on the procedure and individual circumstances.
- Light activity: Commonly resumed within several days.
- Work: Often within approximately one week, depending on the type of work and recovery.
- Strenuous exercise: May be restricted for approximately two to four weeks.
Recovery times are approximate and vary between individuals. Your treating specialist will provide advice based on the procedure performed and your individual circumstances.
Risks and limitations of varicocele embolisation
Common / expected effects
Varicocele embolisation is generally a safe procedure, and serious complications are very rare. You may have mild bruising or tenderness at the catheter entry site, or a dull ache in the groin, lower back or scrotum for a few days.Rare complications
Rare complications include a reaction to contrast dye or movement of the material used to block the vein. The procedure uses X-ray guidance, which involves a small amount of radiation exposure.Limitations & recurrence
Occasionally, the vein cannot be reached or treated as planned. Recurrence after embolisation is uncommon, although individual results vary. Embolisation cannot guarantee relief from pain or an improvement in fertility. Dr McConnell will discuss your individual risks and the likely benefits before you decide whether to proceed.Recovery after varicocele embolisation
Varicocele embolisation is usually a day procedure. After a short period of observation, most patients can go home the same day. Mild bruising at the catheter entry site or a dull ache in the groin or scrotum can occur as the treated vein settles. Most people can return to desk work within one to two days. Heavy lifting and strenuous exercise should be avoided initially; exercise can often be resumed after about a week. If your work is physically demanding, you may need more time. Dr McConnell’s team will give you specific instructions about caring for the puncture site, driving and returning to activity.
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Day of treatment
Day procedure with a short observation period before going home the same day.
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First 1–2 days
Mild bruising or a dull ache in the groin or scrotum may occur as the treated vein settles.
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Return to work
Many people can return to desk work within 1–2 days. More physical work may require additional recovery time.
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Return to exercise
Light activity can resume as you feel comfortable. Heavy lifting and strenuous exercise are usually avoided for about one week.Discuss varicocele embolisation with Dr Ryan McConnell
Varicocele embolisation is a minimally invasive treatment performed through a small venous puncture, without a surgical incision in the scrotum. During your consultation, Dr McConnell can review your symptoms, imaging and other relevant investigations, discuss whether embolisation may be appropriate, and explain the expected recovery, potential benefits and risks. Dr Ryan McConnell (BMBS, FRANZCR) is an interventional radiologist and Head of Department, Interventional Radiology, at Northern Beaches Hospital. He consults in Manly and St Leonards, and performs varicocele embolisation at Northern Beaches Hospital and the Mater Hospital, North Sydney. Complete the form below and our team will contact you to discuss your enquiry and arrange a consultation where appropriate. Please avoid including highly sensitive medical information in the form.
A GP referral is needed to book. Phone (02) 9023 9970.
Frequently asked questions about varicocele embolisation
What is varicocele embolisation and how does it work?
Varicocele embolisation is a minimally invasive, image-guided treatment performed by an interventional radiologist. It is usually done under local anaesthetic with mild sedation. A thin catheter is passed through a small puncture in a vein in the neck, groin or arm. Using live X-ray images, the catheter is guided to the testicular vein. Coils, a liquid embolic agent or both are then used to close the abnormal vein, so blood drains through other veins instead. No surgical incision in the scrotum is needed.
What is the expected recovery time after the procedure?
Varicocele embolisation is usually a day procedure, and most patients can go home after a short period of observation. Mild bruising at the catheter entry site or a dull ache in the groin or scrotum can occur for a few days.
Most people can return to desk work within one to two days. Heavy lifting and strenuous exercise should initially be avoided and can often be resumed after about a week. Recovery varies between individuals, and you will be given specific instructions following your procedure.
How does varicocele embolisation compare with surgery?
Both embolisation and surgical repair aim to stop abnormal blood flow through the veins contributing to the varicocele. Surgery treats the affected veins through a surgical incision, whereas embolisation treats them from within the blood vessels through a small venous puncture.
Embolisation is usually performed without a surgical incision in the scrotum and generally has a relatively short recovery period. The most appropriate treatment depends on your anatomy, symptoms, previous treatment and individual circumstances.
What are the risks of varicocele embolisation?
Varicocele embolisation is generally a safe procedure, and serious complications are very rare. Temporary effects can include bruising or tenderness at the catheter entry site and a dull ache in the groin, lower back or scrotum for a few days.
Rare complications include a reaction to contrast dye, infection, injury to a blood vessel or movement of the material used to block the vein. X-ray guidance is used during the procedure, which involves a small amount of radiation exposure. Your individual risks will be discussed before treatment.
Can a varicocele come back after embolisation?
Recurrence or persistence of a varicocele can occur after treatment. Recurrence after embolisation is uncommon, although results vary between studies and individual patients.
In some cases, additional collateral veins may contribute to recurrence and further assessment or treatment may be required.
Can varicocele embolisation improve fertility?
A varicocele can be associated with abnormal semen parameters in some men, and treatment may improve semen concentration, movement (motility) or other measures in selected patients. However, improvement in semen analysis does not guarantee pregnancy.
Where fertility is the main reason for considering treatment, the decision should take into account the varicocele, semen analysis and other relevant fertility factors.
Will I need a general anaesthetic?
Varicocele embolisation is usually performed under local anaesthetic with mild sedation. A general anaesthetic is therefore not usually required.
The anaesthetic and sedation plan will be discussed with you before the procedure and may vary depending on your individual circumstances.
How much does varicocele embolisation cost?
Costs depend on your health insurance, the hospital and your individual treatment plan. With a valid referral, you can claim a Medicare rebate for your consultation.
If you decide to go ahead with embolisation, you will receive a written estimate of fees before treatment, including what Medicare and your health fund are expected to cover. Our team can answer cost questions when you get in touch.
How soon can I be seen?
Our team will offer you the next available consultation in Manly or St Leonards when you get in touch.
Having your GP referral and any scrotal ultrasound results ready helps us arrange your appointment.
Evidence & references
This page draws on published clinical guidelines, standards of practice and peer-reviewed research on varicocele embolisation.
- Ierardi AM, Biondetti P, Tsetis D, et al. CIRSE Standards of Practice on Varicocele Embolisation. Cardiovasc Intervent Radiol. 2023;46:19–34.
Standards of practice addressing patient selection, technique, safety and outcomes for varicocele embolisation.