Varicocele

Varicoceles

Varicoceles are an important, but often unrecognized cause of chronic groin or scrotal pain. Varicoceles are also associated with infertility. To explain varicoceles, it helps to understand the purpose of veins in the body. Veins help return blood to the heart by preventing backward flow of blood. When valves don’t work or deeper veins are obstructed, blood pools in the congested scrotal veins, resulting in vein distension and increased pressure in the scrotum. Varicoceles are also a common cause of low sperm production and decreased sperm quality, which can cause infertility.

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Symptoms

Men suffering from a varicocele often describe scrotal heaviness and pain that is worsened by prolonged standing and heavy lifting.

  • Pain may be sharp or dull
  • Increased pain with standing or physical exertion
  • Symptoms relieved when you lay down
  • May cause impaired fertility

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How are varicoceles diagnosed?

Unfortunately, symptomatic scrotal varicoceles often go unrecognized and untreated. The diagnosis is confirmed with duplex ultrasound. Because there are other potential causes of chronic groin and scrotal pain, it is important to exclude other causes of pain such as hernia or a testicular mass.

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How are varicoceles treated?

Once the diagnosis of varicocele is made, this condition can often be successfully treated with a minimally invasive procedure called embolization. The embolization procedure requires little or no downtime and is performed in an outpatient setting. In properly selected patients, embolization provides significant relief of symptoms in over 85% of patients who are treated. Successful treatment is also associated with improved fertility in properly selected patients.

Under ultrasound and X-ray guidance, your treating physician will guide a small-diameter flexible catheter (or tube) about the size of a strand of spaghetti into the affected testicular veins. Injection of a liquid contrast agent allows the interventional radiologist to visualize the abnormal refluxing testicular veins and then close these veins using a combination of tiny metal coils and sclerosant. Closing the diseased veins generally relieves the aching scrotal pressure related to the varicocele. After treatment, the catheter is removed and a small dressing is applied. Patients typically return to normal activity the same day following the procedure.

The advantages of varicocele embolization include:

  • Little or no downtime required
  • Performed as an outpatient procedure
  • Minimally invasive, but highly effective
  • Short recovery period

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