Varicocele Recurrence After Surgery: What are My Treatment Options?

What Happens During Embolization? Do I Have An Alternative To A Second Surgery?

It’s disappointing to realize that you may have a varicocele recurrence after surgery. You’ve endured the surgery, the anesthesia, a lengthy recovery time, a month without sexual activity, the expense, and some pain, in hopes it would all be worth it in the end. And it might have been, if you were now back to having a normal quality of life without the problems that varicocele can cause, like pain, infertility, or low testosterone. Now, it’s back. And you really don’t want to go through all that again.

The truth is 1 in 10 men who undergo a surgical procedure for varicocele will have a recurrence. This statistic remains the same regardless of which type of surgery you have, whether it’s an open procedure, microscopic, or laparoscopic.[i]

Additionally, supporting statistics indicate that up to 15 percent of men who undergo surgery for varicocele report that it didn’t completely relieve pain or it didn’t result in adequate pain relief.[i]

RELATED: 30 Stats About Varicocele You Did Not Know

The disadvantages of repeat surgery for varicocele recurrence include:

  • Possible hospital stay.
  • A two-week recovery period.
  • Four-weeks recovery before you can resume sexual activity.
  • More scarring.
  • The possibility of recurrence still exists even after a second surgery.[ii]

Do I Have An Alternative to a Second Surgery?

Before deciding on a second surgery to treat your varicocele, you should know that there is a varicocele treatment without surgery option — a minimally invasive procedure known as varicocele embolization. This procedure is done on an outpatient basis and has several advantages when compared to surgery.

Some of the advantages of varicocele embolization include:

  • A two-day recovery period.
  • A return to sexual activities after only two weeks.
  • No use of general anesthesia.
  • 90 percent long-term success rate.
  • Cost effective.
  • No scarring.[ii]

RELATED: 9 Things You Need to Know About Varicocele Embolization

All procedures to resolve varicocele will probably relieve pain and discomfort almost immediately. For men facing infertility due to varicocele, treatment may normalize testosterone levels and improve sperm count and quality.[ii] However, it’s important to keep in mind that there is a definite difference between procedures when you look at long-term success rate and recovery times.

The amount of post-operative care required for men who undergo surgery is different from those who undergo embolization. Surgical patients have to keep the surgical area dry until the incision site has completely healed and the dressings have been removed (generally around 2 weeks), and they must avoid heavy lifting for 1 – 2 weeks.[iii] Embolization patients can return to most normal activities after only a couple of days.[ii]

Studies have shown embolization is clearly effective when chosen as a method of treatment for men who experience varicocele recurrence after surgery.[iv]

What Happens During Embolization?

An interventional radiologist performs the embolization procedure. The radiologist will make a nick in the skin and thread a small catheter through this nick and into a vein, usually in the groin. This catheter is then used to place small metal coils, and/or a sclerosing agent into the dilated veins. This results in the malfunctioning veins being blocked from blood flow, which forces the blood flow to be diverted to healthy veins and restores blood flow to the circulatory system.[v] The return of normal blood flow resolves other problems caused by varicocele. Testosterone can be elevated to normal levels and there are increases in sperm quantity and quality, although these outcomes can take 3 – 4 months to achieve.[iv]

There are fewer risks associated with embolization than with surgery. There is always risk of infection whenever any device is inserted through the skin, but the Society of Interventional Radiologists insists that a small nick such as the one used in the embolization procedure carries virtually little to no risk of infection. According to statistics, there is a greater risk of infection with surgery because there is an actual incision made in the groin.[ii]

The most serious risks of embolization are:

  1. Possible allergic reaction to the embolization agents.
  2. Possible allergy to the contrast solution used to visualize the veins.
  3. The small chance that the embolization material may migrate to other areas of the body.[vi]

According to the National Institutes of Health, complications of varicocele embolization are uncommon and usually not serious.[vii]

For men who have a recurrence of varicocele after surgery, there is a minimally invasive option that is deemed a viable, convenient alternative. Embolization offers a relatively painless option to correct your varicocele while offering long-term success.

VAR Exploring Your Varicocele Treatment Options


Sources:
[i] http://infertility.about.com/od/causesofinfertility/a/Varicocele-And-Infertility.htm
[ii] http://www.sirweb.org/patients/varicoceles/
[iii] http://my.clevelandclinic.org/health/diseases_conditions/hic-varicocele
[iv] http://www.ncbi.nlm.nih.gov/pubmed/18375298
[v] http://www.mayoclinic.org/diseases-conditions/varicocele/basics/treatment/con-20024164
[vi] http://www.radiologyinfo.org/en/info.cfm?pg=Varicocele
[vii] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2422968/