Information for Patients Undergoing Varicocele (pronounced vari-co-seal) Embolisation


This leaflet tells you about the procedure known as varicocele embolisation, explains what is involoved and what the ppossible risks are. It is not meant to be a substitute for informed discussion between you and your doctor, but can act as a starting point for such discussion. The varicocele embolisation is likely to be done as a pre-planned procedure, and you should have had plenty of time to discuss the situation with your consltant and the radiologist who will be doing the procedure, and perhaps even your own GP, before you sign the consent form.

What is a varicocele embolisation?

A varicocele is an abnormality of the veins that take blood away from the testicle. he veins become bigger and more obvious, rather like varicose veins in the leg. Embolisation is a way of blocking these veins, and therefore making them less obvious and causing the varicocele disappear, without an operation.

Why do I need a varicocele embolisation?

Varicocele can cause various problems, including intertility. In the past, an open operation would have been necessary to get rid of the varicocele, but now it can be treated by the technique of embolisation.

Who will be performing the varicocele embolisation?

A consultant interventional Radiologist. Radiologists are trained in using x-ray equipment, and also in interpreting the images produced. They need to look at these images while carrying out the procedure.

Where will the procedure take place?

In the x-ray department, in a special "screening" room, which is adapted for specialised procedures.

How do I prepare for variococcele embolisation?

You need to be an in-patient in the Surgery Day Case Unit. You will probably be asked not to eat for four hour before hand, though you may be told that it is alright for you to drink some water. You may receive a sedative to releave anxiety. You will be asked to put on a hospital gown. As the procedure is generally carried out using the big vein in the groin, you ma be asked to shave the skin around this area. If you have any allergies, you must let your doctor know. If you have preiviously reacted to intravenous contrast medium, the dye used for kidney x-rays and CT scanning, then you must also tell your doctor about this.

What actually happens during variococele embolisation?

You will lye on the x-ray table, generally flat on your back. You will have a monitoring device attached to your chest and finger, and may be given oxygen through small tubes in your nose The radiologist will keep everything as sterile as possible, and will wear a theatre gown and operating gloves. The skin near the point of insertion, probably the groin, will be swabbed with antiseptic, and then most of the rest of your body covered with a theatre towel. The skin and deeper tissues over the vein will be anacsthetised with local anaesthetic, and then a needle will be inserted into the large vein in the groin. Once the radiologist is saticfied that this is correctly positioned, a guide wire is placed through the needle, and into the vein. Then the needle is withdrawn alowing a fine plastic tube, called a catheter, to be place over the wire and into the vein. The radioogist uses the x-ray equipment to make sure that the catheter and the guid wire are moved into the right posistion, into the variococele, and then the wire is withdrawn. The radiologist can block the abnormal veins, either by injecting a special fluid down the catheter, or by passing down small metal coils. These metal coils are like small spings, and cause the blood around then to clot and conciquently block the vein. The radiologist will inject small amounts of special dye, called contrast medium, down the catheter, to check that the abnormal veins are being block satisfactorily. Once they are blocked completely, the catheter will be removed. The radiologist will then press firmly on the skin entry point for several minutes, to prevent any bleeding.

Will it hurt?

When the local anaesthetic is injected, it will sting to start with, but this soon passes off, and the skin and deeper tissues should then feel numb. After this, the procedure should not be painful. There will be a nurse, or another member of staff, standing next to you and looking after you. If the procedure does become uncomfortable for you, then they will be able to arrange for you to have some pain killers through the needle in your arm. You will be awake during the procedure, and able to tell the radiologist if you feel any pain, or become uncomfortable in any other way.

How long will it take?

Every patient situation is different, and it is not always easy to predict how complex or straightforward the procedure will be. Generally, the procedure will be over in about half an hour, but you may be in the x-ray department for about an hour or so.

What happens afterwards?

You will be taken back to your ward on a trolley. Nurses on the ward will carry out routine observations, such as taking your pulse and blood pressure, to make sure that there are no untoward effects. They will also look at the skin entry point to make sure that there is no bleeding from it. You will generally stay in bed for a few hours, until you have recovered. You may be allowed home on the same day, or kept in hospital overnight.

Are there any risks or complications?

Variococele embolisation is a very safe procedure, but there are some risks and complications that can arrise. There may occasionally be a small bruise, called a haematoma around the site where the needle has been inserted, and this is quite normal. If this becomes a large bruise, then there is the risk of it getting infected, and this would then require treatment with antibiotics. Very rarely, some damage can be caused to the vein by the catheter, and this may need to be treated by surgery or another radiological procedure. Unfortunatley, there is always the possibility that although the variococele seems to have been cured to start with, months or even years later, it may come back again. If this happens, then the procedure may need repeating, or you may be advised to have an operation. Dispite these possible complications, the procedure is normally very safe, and is carried out with no significnt side effects at all.


Some of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion about your treatment with the doctors looking after you. Do satisfy yourself that you have receive enough information about the procedure, before you sign the consent form.

Varicocele embrolisation is considered a very safe procedure, designed to prevent you having a larger operation. There are some slight risks involoved, and although it is difficult to say exactly how often these occur, they are generally minor and do not happen very often.