Interventional Radiology and Fluoroscopy
What is a varicocele embolisation?
Varicocele embolisation is an image-guided procedure that uses a catheter to place tiny coils and/or a liquid substance in a blood vessel to divert blood flow away from a varicocele.
A varicocele is an enlarged vein in a male’s scrotum with reversed or stagnant blood flow. It can cause testicular pain, and/or swelling and subfertility. A clinical examination can confirm the presence of a varicocele and an ultrasound examination may allow further evaluation of the findings. Varicocele embolisation safely relieves that pain and swelling and may improve sperm quality for infertile couples.
Are there any risks?
Serious risks and complications of having a varicocele embolisation are very rare. However, as with any procedure, some risks or complications may occur.
- Any procedure that penetrates the skin carries a risk of infection. The chance of infection requiring antibiotic treatment appears to be less than one in 1,000.
- There is a very slight risk of an allergic reaction if the procedure uses an injection of contrast material.
- Any procedure that places a catheter inside a blood vessel carries certain risks. These risks include damage to the blood vessel, bruising or bleeding at the puncture site, and infection. The doctor will take precautions to mitigate these risks.
- There is always a chance that an embolic agent can lodge in the wrong place and deprive normal tissue of its oxygen supply.
- There is always a slight chance of cancer from exposure to radiation. However, the benefit of this treatment outweighs the risk.
The gyneacologist or radiologist will discuss the possible risks with you before. Please ask them if you have any concerns or would like any further information.
What do I need to do to prepare for the procedure?
You can come into hospital, have a varicocele embolisation and go home the same day.
- Please let us know if you are taking any medicines that thin the blood (for example Warfarin, Rivaroxaban, Dabigatran, Apixaban), as these may need to be withheld temporarily before the procedure. Call the Radiology Day Unit Sister for advice as soon as you get your appointment letter on 01642 854332.
You do not have to stop eating before the procedure, but you will be lying flat, so you should have a light breakfast. You may drink water up to the procedure.
For patients under 18 please contact the Radiology Day Unit up to 1 week prior to your appointment for further information on 01642 854332 or 854822.
What happens before the varicocele embolisation?
After you have arrived at the radiology day unit, you will be examined and assessed by a radiology nurse and given a hospital gown to wear.
You will be seen by a radiologist or radiographer (a health care professional who uses imaging machines to diagnose and treat illnesses) who will discuss the procedure with you. You will be given the opportunity to ask any questions you have.
Giving my consent (permission)
The staff caring for you will ask your permission to perform the procedure. If you decide to go ahead, you will be asked to sign a consent form that says you have agreed to the procedure and that you understand the benefits, risks and alternatives. If there is anything you don’t understand or you need more time to think about it, please tell the staff caring for you.
How is the varicocele embolisation carried out?
You will be taken into the x-ray room, and asked to lie flat on the table. The Radiologist will inject local anaesthetic into your neck or groin. Once the skin is numb, he or she will put a needle into a large vein under the skin.
A guidewire is passed through the needle, followed by a narrow tube (catheter), which is steered under X-ray control into the enlarged vein that drains blood from the testicle. When this tube is in the correct position, the radiologist will inject coils or a special liquid to stop the flow of blood from the testicle.
They will take further X-rays to confirm that the abnormal veins have been blocked completely. The X-ray catheter will be removed and the Radiologist will press firmly on the skin puncture point for several minutes to prevent any bleeding.
Will I feel any pain?
The local anaesthetic can sting a bit, however afterwards you should not feel any pain during the procedure. You may however feel some discomfort after the procedure when the local anaesthetic wears off. You may want to take paracetamol tablets for the pain. You may also have a little bruising.
What happens after the procedure?
Following the examination, you may need bedrest on the Day Unit. You should arrange for a relative or friend to bring you to hospital and collect you. It will also be necessary for a friend or relative to remain with you at home until the following morning.
You must not drive yourself home or use public transport.
The person collecting you should telephone the ward on 01642 854332 to confirm the time of your discharge.
The day after the procedure you should rest. If you have a desk job, you can return to work the day after this. If you have a heavy manual job, you should allow another 2 or 3 days. You can return to sport 5 days following the procedure.
Useful websites
https://www.baus.org.uk/_userfiles/pages/files/Patients/Leaflets/Varico%20emb.pdf
Radiation dose and risk
X-rays use ionising radiation which can cause cell damage that may, after many years or decades, turn cancerous. The risk of this happening is very small compared to the normal lifetime risk of developing cancer which is 1 in 2.
We are also all exposed to background radiation every day. The risk of long-term effects is considered when the healthcare team decide whether someone needs an x-ray examination and radiation doses are kept as low as possible.
For this examination radiation dose levels are typically equivalent to around 1 to 2 years of background radiation. The associated risk is less than 1 in 1000 – Low.
Is there anything I should tell the staff?
For patients who have ovaries and are between the ages of 12 and 55, the x-ray department has a legal responsibility to ensure that this examination is performed within TEN DAYS of the first day of your menstrual period.
Contact us
If you require further information, please contact us on:
Telephone: 01642 854822
Email: [email protected]
Patient experience
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.
To ensure we meet your communication needs please inform the Patient Experience Department of any special requirements, for example; braille or large print.
T: 01642 835964
E: [email protected]