Have you been diagnosed with a varicocele, (or varicose veins in the scrotum)? Varicoceles are a treatable condition that affects 15% of all men.[i] If you’re like most men, at this point you’re probably considering your varicocele treatment options. You may be wondering about life after treatment. In particular, you may be wondering when it’s safe to have sex after varicocele surgery, and how that waiting time compares to when you can have sex after varicocele embolization.
Varicocele embolization is a minimally invasive procedure that treats varicoceles. Embolization involves the placement of coils within the veins of the varicocele to close off the blood vessels and redirect the blood flow. Varicoceles are a common cause of male factor infertility, and varicocele embolization is a way to treat varicocele related infertility without surgery.[ii] Before deciding on which treatment is right for you, you need to consider the risks and benefits of all of your options. You should educate yourself about both varicocele embolization and varicocele surgery side effects.
The amount of time you should wait before you can return to normal sexual activity varies depending upon which treatment you choose. Whether you decide to have surgery or varicocele embolization, you should always follow the advice of your doctor as to when you can resume sexual activity.
Varicocele surgery involves tying off the veins that are feeding into the varicocele. There are several ways that a surgeon can gain access to the veins to treat a varicocele. In the microsurgical and open surgery approaches, an incision can be made in the inguinal canal, or the groin. Alternatively, the laparoscopic approach requires that several small incisions be made in the abdomen to allow for the use of a camera and surgical instruments. The laparoscopic and open approaches involve general anesthesia, which means you will be completely unconscious during these procedures. The typical recovery time after any of the surgical treatment options for varicoceles is 2-3 weeks. You’ll probably spend the first night of recovery in the hospital after the surgery. Exercise should be avoided for the first 10-14 days. To allow for appropriate healing of the incisions as well as the veins, it is generally recommended men wait 3 weeks after surgery to have sex. [iii]
Varicocele embolization is performed by an interventional radiologist, who will make a small nick in the skin of the right groin, to gain access to the femoral vein. Using x-ray technology to see the path, a thin tube known as a catheter is advanced through the nick in the skin into the veins in the scrotum. A special dye, (or “contrast agent”) that can be seen on x-ray is used to see the position of the catheter and the veins. Once the veins to be treated are identified, a small coil, or coils and, possibly, a sclerosant (a solution that helps close off the affected veins) are placed within the veins. The procedure takes 1-2 hours and at the end there is a mere bandage over the small nick in the groin. Typically, local anesthetic as well as moderate sedation are used to treat any pain or discomfort during the procedure. Varicocele embolization is an outpatient procedure, and you will be able to go home the same day. The recovery time is about 1-2 days, but you should avoid exercise for the first 7-10 days. Sexual intercourse is generally permitted 1-2 weeks after the procedure.[iv]
RELATED: Read our guide comparing varicocele embolization to varicocele surgery
Sex After Treatment
Your sexual function should not be different after you have either treatment. If you waited the recommended amount of time to allow for healing, sex should not be painful.
Sperm After Treatment
Both treatments, surgery and varicocele embolization, can improve sperm count and quality. While you can return to normal sexual activity within 1-2 weeks after varicocele embolization and 4 weeks after surgery, it will take time, typically around 3 months for there to be any noticeable improvement in sperm count and quality.[v] This is because it takes about 3 months for new sperm to develop.
If you’re interested in varicocele embolization as a non-surgical treatment for varicocele, the next step is to find an interventional radiologist in your area. Set up a consultation to review your medical history to determine if this minimally invasive treatment is an option for you.
[i] Choi, W., and Kim, S., Current Issues in Varicocele Management: A Review. World J Mens Health, 2013. 31(1): p. 12-20.
[ii] American Pregnancy Association. Male Infertility: Causes, Treatment and Prevention. http://americanpregnancy.org/infertility/male-infertility
[iii] Weill Cornell Medical College Cornell University, A Guide to Varicocele Repair. http://www.harryfisch.com/varicocele-repair.html
[iv] UAB Medicine, Varicocele Embolization-For Patients. http://www.uabmedicine.org/documents/142028/233977/Varicocele+Embolization/9ee27e00-6640-4890-905a-91cfce4e417b?version=1.0
[v] Mayo Clinic, Varicocele Treatments and drugs. http://www.mayoclinic.org/diseases-conditions/varicocele/basics/treatment/con-20024164