There are two main treatment options for a varicocele:
Varicocele embolization is a minimally invasive procedure to block veins draining the varicocele in thee scrotum. It is performed using both ultrasound and low dose x-ray guidance. It is a day-only procedure and performed with local anaesthetic and ‘twilight sedation’.
A small hollow tube (catheter) is inserted in a vein in the neck or groin. Under image guidance, the catheter is advanced to the testicular vein. The testicular veins are blocked with coils and liquid (sclerosant). This prevents backflow within the testicular vein, shutting down the varicocele.
The procedure takes approximately 1 hour and patients are discharged home the same day.
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.
Since patients with a varicocele usually don’t have symptoms, many men who are diagnosed may not need treatment.
Varicocele treatment is an option when symptoms are severe or if patients are having trouble conceiving a child and a varicocele is contributing to infertility.
Discussing your case with a GP or an interventional radiologist will help explore your treatment options. If you have recently been diagnosed with a varicocele, you can book a consultation with Dr McConnell and he will discuss your treatment options with you.
Varicocele embolisation has the following benefits:
Varicocele embolisation is a low-risk procedure with complications significantly less than 1%. Though uncommon, some complications or risks of varicocele embolisation include:
Technical success of varicocele embolization is over 95%.
89% of men are reported to have relief of scrotal pain following embolisation.
Varicocele treatment improves sperm count and quality in 60-80% of men. Successful pregnancy is reported in up to 50% of sub-fertile couples after varicocele embolisation.
In patients with low testosterone and a varicocele, embolisation has been shown to raise testosterone levels by up to 25%.
The embolization procedure will be performed in hospital as a day-only procedure. Dr Ryan McConnell has private hospital appointments at Nepean Private Hospital, Northern Beaches Hospital and Macquarie University Hospital. He also has public hospital appointments at Nepean Hospital and Royal Prince Alfred Hospital.
You will need to fast for 6 hours prior to your procedure. Take your regular medications as normal with a sip of water.
Post-procedure, you will be transferred back to the ward for bed rest and observation for 4 hours. You will be able to eat and drink immediately post-procedure.
Recovery post varicocele embolisation is usually very short. You will not be able to drive yourself home after having sedation so transport will need to be arranged. It is advised you avoid heavy lifting for a week and avoid any sexual activity for a couple of weeks following your procedure. Depending on your job, you may be able to return to work the next day. For up to a week after your procedure, you may experience mild discomfort in your back and abdominal area.
You will be provided with our contact details in case you wish to ask any questions post-discharge.
You will receive a phone call from Dr McConnell’s consulting rooms 2 weeks post procedure to see how you are progressing. Dr McConnell will see you in his clinic 6 weeks post procedure.