Varicocele Treatment

Varicoceles Facts

A varicocele is a nest of varicose veins around the testicle and may be unsightly, cause pain, or cause testicular atrophy or under development with associated fertility problems. When valves fail in the veins that drain this nest of veins, the blood pools and enlarges these 'varicose' veins around the testicle causing a varicocele which can have the appearance of a “bag of worms”

  • Approximately 10 percent of all men have varicoceles
  • 30 percent of infertile males have a varicocele
  • Highest occurrence in men aged 15-35
  • Usually left sided

Pain - aching pain when an individual has been standing or sitting for long periods of time and pressure builds up on the affected veins. Typically, painful varicoceles are prominent in size.

Fertility Problems - There is an association between varicoceles and infertility. The incidence of varicocele increases to 30 percent in infertile couples where the male is shown to have low or abnormal sperm count. Some experts believe varicoceles, cause infertility by raising the temperature in the scrotum and decreasing sperm production.

Testicular Atrophy - Shrinking of the testicle is another sign of varicoceles. Often, once the testicle is repaired it will return to normal size if treated when the patient is young.

Cosmetic - many males, and females, find the 'bag of worms' of a prominent varicocele quite unsightly irrespective of the presence of pain or atrophy

In men with reduced fertility and a varicocele, embolization is equally effective in improving fertility as surgical ligation without the associated recovery problems. Pregnancy rates and recurrence rates are comparable to those following surgical varicocelectomy.

In one study, sperm concentration improved in 83 percent of patients undergoing embolization compared to 63 percent of those surgically ligated.

The treatment options are surgery or embolization

Given the choice most patients express a strong preference for embolization.

Varicocele Embolization

The patient requires a mild IV sedation and local anaesthesia. The procedure takes about an hour and the patient is relaxed and pain free.

A tiny nick (3mm) is made in the skin at the groin using local anaesthesia, through which a thin catheter is passed into the femoral vein, directly to the testicular vein. Dr Robertson, using real-time X-ray control, then injects contrast dye to provide direct visualization of the veins so he can map out exactly where the problem is and where to embolize, or block, the vein using coils, or particles which reduces pressure on the varicocele. By embolizing the vein, blood flow is re-directed to other healthy pathways. Essentially, the incompetent vein is "shut off" internally by preventing blood flow, but without the need for surgery.  

Recovery Time

Very fast recovery - average of one to two days for complete recovery

  • Day procedure, no overnight stay required
Does the procedure hurt?No, Local anaesthesia and sedation onlyNo, General anaesthesia
How long do I stay in hospital?No overnight stay requiredAbout 25% require an overnight stay
When can I return to normal work?The next day2-3 Weeks
Is there pain after the procedure?Very little.Yes but managed with analgesia
Will it cause sexual dysfunction?NoNo
Is there any scarring?None on the scrotum only a small 3mm nick in the groin which disappears in a few weeksYes - depending on surgical technique.