Varicocele Embolization
A varicocele is a cluster of dilated veins around the testicle caused by a valve that no longer closes, allowing blood to flow backwards. Embolization closes that refluxing vein from the inside through a pinhole in the neck or groin vein, so the varicocele collapses. There is no scrotal incision, no general anaesthetic and no overnight stay.
Dr. Mohamed El Ghobashy · Consultant Interventional Radiologist
What it treats
- •Aching, dragging or heaviness in the scrotum, typically worse at the end of the day
- •Varicocele found during a fertility workup with abnormal semen parameters
- •Visible or palpable scrotal veins confirmed on Doppler ultrasound
- •Varicocele that has recurred after open or laparoscopic surgery
Who is a candidate?
- Men with a symptomatic varicocele confirmed on scrotal Doppler ultrasound
- Men with abnormal semen analysis and a clinically significant varicocele
- Men who want to avoid general anaesthesia and a surgical wound
- Men with recurrence after previous varicocelectomy, where repeat surgery is difficult
How the procedure works
- 1
Assessment
Scrotal Doppler ultrasound confirms the varicocele and grades the reflux. Semen analysis is reviewed if fertility is the reason for treatment.
- 2
Access
Local anaesthetic is placed over a vein at the neck or the groin and a fine catheter is introduced. The testicle itself is never punctured.
- 3
Embolization
The catheter is guided into the testicular vein and a venogram maps the refluxing channels. Coils, and often a sclerosant, are placed to close the vein along its length.
- 4
Completion
The catheter is removed and a small dressing is applied. Most men are up and walking within an hour or two and go home the same day.
Recovery
Most men are back to office work in one to two days and to the gym in about a week — considerably faster than after surgery, because there is no wound in the scrotum or groin. Mild ache or bruising for a few days is normal. Where treatment was for fertility, a repeat semen analysis is usually arranged at three to six months, since sperm production takes that long to reflect the change.
Discuss this procedure
Private consultations and procedures are at Andalusia Hospitals, Maadi. Kasr Al-Ainy is Dr. El Ghobashy's academic post at Cairo University and does not take private cases.
Frequently asked questions
How is this different from varicocele surgery?
Surgery reaches the veins from the outside through an incision and ties them off. Embolization reaches the same veins from the inside through a pinhole and closes them with coils. Success rates are comparable in appropriate patients, but embolization avoids a wound, general anaesthesia and most of the downtime.
Will it improve my fertility?
Semen parameters improve in a substantial proportion of men after treatment of a clinically significant varicocele, but no procedure can promise a pregnancy — fertility depends on both partners. This is discussed honestly at consultation before anything is booked.
Is the testicle at risk?
The testicle is not punctured and its arterial supply is not touched — only the refluxing vein above it is closed, and drainage continues through other normal channels.
Other procedures
This page is general information, not medical advice for an individual. Whether a procedure suits you depends on your imaging, your history and an in-person assessment.