Having Varicocele Embolization

A varicocele (VAR-ih-koe-seel) is a swelling in the veins above a man's testicles. It may cause pain, swelling, or infertility. Varicocele embolization is a procedure to treat the enlarged vein. Your healthcare provider will use a long thin tube (catheter) and a tiny coil or medicine to block the flow of blood to the varicocele. The blood will then flow in the veins around the blocked vein. The varicocele will go away.

What to tell your healthcare provider

Tell him or her about all the medicines you take. This includes over-the-counter medicines such as ibuprofen. It also includes vitamins, herbs, and other supplements. And tell your provider if you:

• Have had any recent changes in your health, such as an infection or fever

• Are sensitive or allergic to any medicines, latex, tape, contrast dyes,  or anesthetic medicines (local and general)

Tests before your procedure

Before your procedure, a healthcare provider will examine you and ask questions about your health history. This includes an exam of your scrotum and testes. He or she may also check your heart and lungs. You may have certain tests such as ultrasound exam of your scrotum and testes. This test allows your healthcare provider to see the varicocele.

Getting ready for your procedure

Talk with your healthcare provider about how to get ready for your procedure. You may need to stop taking some medicines before the procedure, such as blood thinners and aspirin. If you smoke, you may need to stop before your procedure. Smoking can delay healing. Talk with your healthcare provider if you need help to stop smoking.

Also, make sure to do the following:

• Ask a responsible family member or friend to take you home from the hospital

• Don't eat or drink after midnight the night before your surgery

• Follow all other instructions from your healthcare provider

You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully. Ask questions if something is not clear.

On the day of your procedure

Your procedure will be done by an interventional radiologist. This is a doctor who specializes in image-guided procedures. He or she will work with a team of specialized nurses. Ask your doctor about the details of your procedure. The whole procedure may take a few hours. In general, you can expect the following:

• You will be given medicine (sedation) to make you relaxed, comfortable, and sleepy during the procedure.

• A healthcare provider will watch your vital signs, like your heart rate and blood pressure, during the surgery.

• You will receive a shot (injection) of numbing medicine (local anesthesia) in your upper thigh. The medicine will stop pain during the procedure.

• Your healthcare provider will clean the area. He or she will then put a needle into a vein in your thigh. He or she will insert a thin, narrow tube (catheter) into the vein.

• X-rays will be used during the procedure. These are to help your healthcare provider move the tube to the correct place in your scrotum. He or she may add dye (contrast material) into the vein to make the X-ray pictures better. You may feel some warmth when this is used.

• Your healthcare provider will use the catheter to put a small coil or a special liquid into the affected vein. This is called a blocking agent.

• The catheter will then be removed. A bandage will be placed over the area where the needle was put in your thigh.

After your procedure

Your vital signs will be watched after the procedure. You will feel sleepy when you wake up. You will likely be able to go home that same day.

Recovering at home

After the procedure:

• You may have a little pain. Your healthcare provider will tell you what to do to lessen the pain.

• If you were given medicine to help you relax, you should not drive or make any important decisions for at least 24 hours.

• You should be able to return to your normal activities in 1 to 2 days.

• Stay away from heavy activities for 7 to 10 days.

Follow-up care

Make sure you follow up with your healthcare provider after the procedure. If you were having problems with infertility, he or she may check your semen. You may need to have an additional procedure if the varicocele returns.