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Varicoceles

varicocele embolization
Varicoceles

A varicocele is a common, non-life-threatening venous condition that is thought to affect up to 15% of all adult men. In fact, in many men, a varicocele may be accompanied by no symptoms and thus go unnoticed. However, for others, a varicocele can cause pain, affect the growth of the testicles, or impair fertility. When this is the case, it’s important to seek out the correct diagnosis and effective treatment.

WHAT IS A VARICOCELE?

A varicocele is an abnormal enlargement of veins in the scrotum. The veins throughout your body carry oxygen-depleted blood back to the heart, and they are equipped with valves to prevent backflow and keep blood moving in the right direction. If those valves don’t work properly, blood pools in the veins. While it is not clear what triggers a varicocele, it is generally thought that it’s caused when those valves fail within the network of small veins that carry blood from the testicle to the testicular vein. Varicoceles occur more frequently on the left side of the scrotum.

Who is at Risk?

A varicocele can affect men of any age. While it is more common among adults, it can also develop in teen boys during puberty, when blood flow increases to the testicles during growth spurts.

What are the symptoms of a Varicocele?

It is entirely possible to have a varicocele and experience no symptoms. However, possible signs of a varicocele include:

  • Dull, aching pain in the scrotum: This pain may become worse over the course of the day while standing for long periods of time, or after physical exertion. Pain from a varicocele tends to improve when the patient lays down.
  • Mass in the scrotum: Over time, a varicocele may become enlarged enough to become visible as a mass above the testicle; often these are described as looking like a “bag of worms.” Smaller varicoceles may be detectable by touch even if they are not large enough to see. (Any scrotal mass should be a reason to see your doctor right away for an accurate diagnosis of the underlying cause.)
  • Difference in testicle size: A testicle affected by a varicocele may be noticeably smaller than the other, due to the impaired blood flow.
  • Fertility problems: Varicoceles are one possible cause of low sperm count or quality.

Complications from a Varicocele

Even if a varicocele isn’t causing pain, it can cause serious complications. When a varicocele impedes the proper circulation of blood in the scrotum, it can negatively affect the health of the testicles. In boys, this can affect the growth of the testicles and hormone production during puberty. In men, it can cause the testicle to atrophy (shrink) over time due to tissue loss.

Varicoceles can also cause fertility problems. The testicles function best at around three degrees below the average core body temperature; their location in the scrotum is intended to keep them at this optimal temperature. When a varicocele allows warm blood to pool in the scrotum, it raises the temperature and can interfere with sperm production.

Diagnosing a Varicocele

To diagnose a varicocele, your doctor will perform a thorough physical exam. You may also undergo a scrotal ultrasound to accurately image the structure of the scrotum and rule out other possible causes for your symptoms. In cases where a varicocele is causing no bothersome symptoms, treatment may not be necessary. However, when the varicocele is accompanied by pain, testicular atrophy, or infertility problems, treatment can seal off the affected vein and redirect blood flow to healthy blood vessels to relieve symptoms.

Varicocele Treatment

When treatment is necessary to correct a varicocele, a surgical procedure may be recommended to close off the affected veins. While this is normally performed as a laparoscopic outpatient procedure, it still requires general anesthesia and significant downtime before returning to work or normal physical activity.

For patients seeking a less invasive treatment, varicocele embolization (or percutaneous embolization) is an effective alternative. In this procedure, an interventional radiologist threads an image-guided catheter to the site of the affected veins and blocks them with a solution or tiny coils. This diverts circulation to healthy veins, reducing swelling and pressure in the varicocele and gradually shrinking it. Embolization is performed as an outpatient procedure under local anesthesia and requires much less downtime than surgery; patients can usually return to work in a day or two and resume exercise in a week to a week and a half.

Effective Treatment Without Surgery

At the Vein & Fibroid Treatment Center, board-certified interventional radiologist Dr. Saleh has over a decade of experience treating venous conditions, including varicoceles, with minimally invasive treatments. Patients recover faster with fewer complications, returning more quickly to an improved quality of life. If you have a troublesome varicocele and would like to learn more about varicocele embolization, contact the Vein & Fibroid Treatment Center here.

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