Varicocele Embolisation

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Procedures › Varicocele Embolisation

About this procedure

This guide provides information about a varicocele embolisation procedure. It includes details about what is involved, how to prepare and what to expect during and after the procedure. Please use this in addition to information from your doctor and nurse.

A varicocele is performed in an interventional radiology suite at IntraCare in Epsom. Your interventional radiologist will be assisted by our team of nurses and other highly skilled personnel.

Both IntraCare and Allevia Hospital will be involved with your care for this procedure. Allevia Hospital is responsible for your admission, preparation and aftercare.

What is a varicocele?

A varicocele is an enlargement of the veins surrounding the testicle, which results from abnormal (reversed) blood flow causing congestion (venous incompetence). Varicoceles can be left sided or bilateral, and can cause local swelling, pain and discomfort, and may be associated with infertility.

What is a varicocele embolisation?

Varicocele embolisation is a procedure in which the abnormal vein(s) are blocked, preventing blood flow from occurring in the wrong direction. Over time, this reduces congestion and causes the varicocele to disappear. When the abnormal veins are blocked, the testicles will continue to drain blood normally by other routes.

Before the procedure

Pre-procedure phone call

A nurse from IntraCare will call you 24–48 hours prior to your procedure to discuss the following information:

Your admission time.
When you should stop eating and drinking.
Medication instructions.
Allergies (including medications, contrast dye, dressings/plasters and food).
Answer any further questions.

Anticoagulation (blood thinner)

If you are taking any blood thinners (e.g. Warfarin, Clexane, Pradaxa, Rivaroxaban), please make this known to IntraCare staff at the time of booking. Your interventional radiologist or oncologist will advise you if you need to stop this medication temporarily for a few days before the procedure.

Other regular medications

Please continue to take these unless advised otherwise by your interventional radiologist. If you are taking a diuretic or water pills (e.g. frusemide, spironolactone), you may need to withhold this on the morning of the procedure.

Reminders for the day of your procedure

If you are on regular medication, please bring this with you in its original packaging.
Please leave all your jewellery and valuables at home. You are welcome to bring your mobile phone in with you.
We recommend wearing loose-fitting clothing and shoes that are easy to slip on/off.
You are encouraged to bring a friend or a family member as a support person before and after your procedure.
Please arrange for someone to drive you home after the procedure, as you will not be able to drive for 24 hours following your procedure.
The planned procedure time is an estimate only and may vary. We will keep you informed of any unexpected delays on the day.

Informed consent

As with any procedure, there are potential risks involved. Your interventional radiologist will explain the procedure, discuss possible risks and answer any questions you may have. Your whānau or support person are welcome to be part of this discussion. You will then be asked to sign the consent form. This will occur either at an earlier appointment or on the day of your procedure.

Your procedure

A varicocele embolisation is performed under conscious sedation and usually takes 60–90 minutes.

Preparation

A small intravenous needle (IV line) will be inserted into a vein in your arm. This will be used to administer medication to help you relax and to keep you comfortable during the procedure.

Once you are in the interventional radiology suite, devices for monitoring blood pressure, heart rate and oxygen levels will be fitted to ensure your safety during the procedure.

The procedure

The right side of your neck is the easiest place to access the vein that leads to the varicocele. This area will be prepared with an antiseptic solution, and then sterile drapes will be placed around your face and the rest of your body to ensure sterility is maintained.

You will feel the local anaesthetic injection around the neck, which will sting for approximately 30 seconds.

A small tube (sheath) will be inserted into a vein on the right side of your neck. Using contrast dye and fluoroscopy, a catheter will be carefully guided into the veins near the varicocele. Once the catheter is properly positioned, a sclerosant or other embolization agent will be injected into the vein, blocking it over several minutes. If you have varicoceles on both sides, this procedure may be performed on both sides.

Once the embolisation commences, you may feel a mild dull ache in the back or groin area. Please inform the interventional radiologist if you are uncomfortable, and pain relief will be given via your IV line.

The process may be repeated for the other (right) testicle using the same sheath in your neck if you have bilateral varicoceles requiring treatment.

After your procedure

You will be transferred from IntraCare to Stella Maris ward, where the Allevia Hospital team will look after you during your recovery. You will be able to sit up straight away but will remain on bedrest for 1.5–2 hours. If appropriate, you will usually be discharged home after 2 hours. Prior to your discharge, the nursing staff will give you advice about your medication, procedure site care and resuming your normal daily activities.

Recovery and discharge

Following your procedure, it is important that you do not drive for 24 hours.
Please ensure you have a family member or friend to drive you home from the hospital, as you may still be under the effects of anaesthesia or sedation.
You will need to arrange someone to be at home with you on the day of your discharge and overnight to support you in your recovery.
Due to the sedation, you may feel lethargic afterwards with reduced concentration. For this reason, for 24 hours after your procedure:
- Do not do any activity requiring strength, concentration, or full alertness.
- Do not make any legal decisions or sign legal documents.

Resuming travel and activities

You will be able to return to work within a week of having the procedure unless your job involves heavy lifting (>5kg).
You can begin light exercise after 1 week.

Medication

Your interventional radiologist may give you a prescription for pain relief (analgesic) to take home. Please use this if you experience any dull, aching pain for the following few days.

Seek immediate medical attention (dial 111 for an ambulance) if there is excessive bleeding from the puncture site or if you are experiencing severe chest pain.

Please show this page and your discharge summary if visiting a GP, after-hours or hospital.

In case of emergency, always call 111.

FAQs

Who do I contact if I have concerns following the procedure?

If you have concerns in the first few days, contact your interventional radiologist, or a nurse at IntraCare.

What do I do if I experience an ache around the pelvic, lower back or testicle region?

You will be sent home with a prescription of pain relief and anti-inflammatories. These should assist in relieving the pain if taken regularly. If the pain persists after a few days, please contact your radiologist, or a nurse at IntraCare.

When can I resume sexual activity?

Embolisation will not affect your sexual function, therefore you may resume sexual activity the day after your procedure. However if this procedure is for fertility purposes, it may take 3 months or more to notice any improvement in fertility.

Is this procedure covered by health insurance?

If you have private health insurance please contact our administration team. IntraCare is affiliated with Southern Cross, NIB and AIA and will help you with the approval process and will discuss options for self-funding. Please contact the administration team on 09 630 1961.

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