What Are MIIPs? / Male Infertility (Varicocele Embolization)

What is a varicocele?

A varicocele is swollen vein in your scrotum. Your scrotum contains your testicle.

What causes varicoceles?

The blood in your scrotum usually leaves your scrotum through a vein. This vein is called the testicular vein. This vein has valves. Valves are structures in veins that allow blood to flow only in the forward direction. Damaged valves let the blood flow backward. The blood can get stuck in the veins in your scrotum. This makes the veins swell up. Swollen veins in the scrotum are called varicoceles.

How do I know if I have a varicocele?

Varicoceles cause pain and swelling in your scrotum. Sometimes you can feel or even see the swollen vein. The way to know for sure if you have a varicocele is by getting an ultrasound of your testicles. The swollen veins in the scrotum can be seen on the ultrasound. Ultrasound uses sound waves to see things in the body. Ultrasound does not use radiation.

What problems to varicoceles cause?

Varicoceles can cause pain and swelling in the scrotum. They can also cause affect your fertility. You might have difficulty getting your partner pregnant.

What are the treatments for varicocele?

Varicoceles can be treated with surgery or a minimally invasive, image-guided procedure (MIIP) called embolization.

What is varicocele embolization?

Embolization is a MIIP used to block off an abnormal blood vessel. The abnormal veins in a varicocele can be blocked off using special materials such as fine metal wire coils, special foam, or special medical glue.

How does the doctor do the procedure?

The procedure is performed by specialized doctors called Interventional Radiologists (IRs). The procedure is done in a room that has ultrasound and X rays for guidance.

The skin of your groin or neck will be cleaned and prepared. The IR physician will numb up your skin. The IR will then insert a small plastic tube into the vein and guide the tube through the veins in the body to the veins of the testicle. The IR will inject a special dye through the tube to make the veins visible on x-ray. Low dose moving x-rays will help the IR guide the tube into the abnormal vein. Once the tube is in the vein, the IR can then block off the vein by injecting different materials for embolization.

How long will the procedure take?

The procedure takes about 30-40 minutes.

What are the possible complications of varicocele embolization?

Varicocele embolization is a safe procedure. Most patients have little to no side effects. The most common side effect is tenderness of the treated vein. Less commonly, patients can experience minor bleeding at the puncture site that resolves by holding pressure.

How successful is the procedure?

In 90-95% of patients who have the procedure, the swollen veins go away. In 5-10% of patients, they return. In patients who still have swollen veins, a second treatment can be performed.

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