Varicocele patients have options, both surgical and non-surgical, to relieve pain and improve quality of life by eliminating troublesome veins. The road to resolving your condition starts with an honest conversation with your doctor about your fears and expectations.
More often than not, doctors suggest a surgical approach in the treatment of varicocele, but for men hoping to find a less invasive route, varicocele embolization is a minimally invasive procedure that serves as an alternative to surgery. Your doctor should know about embolization, but you may have to start the conversation by asking questions regarding the procedure. Below are some of the questions you should be asking.
1. What Does the Varicocele Embolization Procedure Involve?
There is a tremendous difference between a varicocele embolization procedure and surgery. The most obvious difference is the incision. Surgery will always result in an incision, which means there will be a scari. With embolization, there is just a small needle prick that results in minimal or no scarring.ii
Another notable difference is the time each procedure takes. Varicocele embolization is done as an outpatient procedure and only takes about 1 hour, whereas surgery is generally around 4 hours.iii
Some other differences between surgery and the embolization procedures include:
- Surgery is performed by a surgeon, either a urologist or someone who specializes in either microsurgery or laparoscopic surgery. An interventional radiologist performs embolization.iii
- During surgery, the patient receives either general or local anesthesia.iv
- Embolization requires only local anesthesia, and, if desired the patient can ask for mild sedation.iv
- There are fewer and less risky complications associated with embolization than with surgery.v
2. Are There Any Varicocele Embolization Complications?
Complications with an embolization procedure are rare, but as with any medical procedure, it’s important to understand what those complications may be. The primary complication of embolization is a possible allergic reaction to the contrast solution that is used to visualize the dysfunctional veins.vi-vii You should share your allergy history with your doctor and ask whether you may be at risk for an allergic reaction to the contrast solution.
Another complication, although infrequent, is to develop an infection where the nick in the skin is made. Infection is listed as a complication because, in theory, it’s a possibility, however, interventional radiologists agree the risk is negligible because the nick in the skin is so small.ii
Other possible complications may include:
- Bruising where the catheter is inserted.
- Temporary post-procedure nausea.
- A minor backache.
- A build up of fluid around the testicle that can cause swelling in the scrotum, known as [med term alert] hydrocele.
- Recurrence of varicocele.v
3. What are Varicocele Embolization Risks?
Your doctor will be able to explain the risks in detail, but there are basically two potential risks with a varicocele embolization procedure. One is a puncture of an artery. While this risk is remote, a catheter with metal coils moving through a vein does pose a risk of puncture.vi
The second risk is a chance of migrating embolization materials moving to other parts of the body. Whenever an embolization is done and blood flow is shut off from one area, it changes the course of flow in other veins. There is always a possibility that some material from the embolized area will move to another area. This could cause significant problems, depending on where the materials go. Again, this is an infrequent occurrence.vii
4. What is the Varicocele Embolization Cost?
Varicocele embolization is considered to be cost effective when compared to surgical treatment options.viii However, there is more to consider than just the financial cost of the two procedures. An important factor for many men is the cost of their time. Since there is a longer recovery period after surgery, there is a greater potential to have a longer absence from work. Most men can begin to resume normal activity and return to work just a couple of days after an embolization procedure.ix
5. How Successful is Embolization?
Varicocele embolization has about a 90% success rate, and for men who are seeking varicocele treatment for infertility, there is a 30% – 50% success rate for achieving pregnancy.v
A discussion with your doctor about Varicocele Embolization Recovery, in comparison with surgery, is worthwhile. Once you have all the information, you can decide on which treatment option is right for you and your lifestyle.