Varicocele embolisation Patient information leaflet (256kB pdf)
Introduction
We hope this guide will answer your questions about your varicocele embolisation procedure. Please contact the team if you require further information via the details at the end of this leaflet.
What is an varicocele embolisation?
Varicocele embolisation is a minimally invasive procedure that is used to treat veins which are enlarged or not working normally to drain the testicles. These are known as varicoceles. The procedure works by blocking the blood flow to the enlarged vein, which reduces pressure on the varicoceles
Why do I need an varicocele embolisation?
Your doctor should have explained the reason why you need this test. It will help your doctor to decide on the cause of your symptoms, giving clearer information to the specialists treating you. A varicocele can cause discomfort in the scrotum, which is often worse when standing, exercising, or cycling. They are sometimes diagnosed during the investigation of infertility, and treatment may help your sperm count. There are a number of ways to treat varicoceles, including open groin surgery, laparoscopic (keyhole) surgery, and minimally invasive interventional radiology. Interventional radiology uses X-rays to guide a small tube to the vein to block it with only a small 3-4mm incision in the groin. It is performed as a day case procedure.
What are the associated risks?
X-Ray radiation: All x-ray procedures involve exposure to radiation in varying amounts. The dose you get from a medical x-ray is very low and your doctor along with the radiologists have determined that the benefits of having the examination outweigh potential risks. The radiographer is present throughout your test making sure that the radiation dose is kept as low as reasonably possible and the duration and level of x-rays are kept to a minimum.
Allergic reaction: A very small number of patients have an allergic reaction to the contrast medium (x-ray dye). This can be minor, severe, or even life threatening but the chances of this occurring are very rare. If you get an itchy rash or difficulty breathing during the procedure tell a member of staff, the team will provide appropriate treatment. Before your examination begins the radiology staff will ask you a series of questions about your medical history, including any allergies you may have. This will help us assess if you are at risk of an allergic reaction to the x-ray dye.
The Procedure: Varicocele embolisation is a very safe procedure, but as with any medical procedure, there are some risks and complications that can arise. There may occasionally be a small bruise called a haematoma around the site where the needle has been inserted into the vein. This will go away in a week or two. A few patients may experience mild discomfort in the loin or scrotum afterward, which rarely lasts more than a few days. There is a very small risk of a coil, used to block the vein, migrating to your lungs. If this happens and it cannot be retrieved, it is very unlikely to cause any problems other than a cough and mild chest pain for a few days. Rarely, it may not be possible to obtain a satisfactory position for embolisation, in which case a surgical operation may be offered. Unfortunately, there is a possibility that the varicocele may come back again. This may also happen after any surgical treatment. If this happens, then the procedure may be repeated, or you may be advised to have an operation.
Preparing for your procedure
Please do not have anything to eat for 4 hours prior to your procedure. You may still drink clear fluids such as water. If you are unsure or have questions about your preparation, contact your doctor or the X-ray department for advice. Please leave any jewellery or valuables at home. Please contact the booking team before your appointment if:
- you are or think you may be pregnant
- you have had a previous allergic reaction to contrast medium (X-ray dye) or are allergic to iodine.
- you are a diabetic taking Metformin.
- you weigh over 30 stone/190 kilograms
- you plan on using hospital transport or need a hoist to transfer
- you require an interpreter – please inform us as soon as you receive your appointment letter, and we will arrange an interpreter for you
If you are unsure or have questions about your preparation, contact your doctor or the X-ray department for advice.
Allergies
If you have asthma or any allergies, especially to contrast medium (x-ray dye), please inform us in advance.
Medication
Please continue to take all medications as usual prior to your examination
Getting to us
Once you have arrived at The Princess Alexandra Hospital (Hamstel Road, Harlow, Essex,
CM20 1QX), follow the signage to the radiology reception, which is located on the ground floor, green zone. Please let the radiology receptionist know that you have arrived for your appointment.
When should I arrive?
Please arrive in the radiology department at your given appointment time. A notification
through text or letter should have been sent to you to confirm this appointment.
Can someone stay with me in hospital?
You may have a friend or relative attend with you, but they will be asked to stay in
the waiting area while you have your procedure.
Children are not allowed in the waiting area unattended. Our staff are not permitted to
supervise children, so please ensure child care arrangements are in place to avoid your
tests being rescheduled.
The day of the procedure
You will be shown to a cubicle and asked to undress and put on a gown; please bring a dressing gown if you have one. You may also be asked to remove jewellery, dentures, glasses, or other metal objects, which may show up on the X-rays.
The procedure
Your identification will be checked by a nurse or radiographer, and a brief history will be taken; please tell the radiologist what medication, severe allergies, choking episodes, or other medical conditions you may have, such as thyroid disease and diabetes. Before the procedure, the interventional radiologist will explain the procedure and ask you to sign a consent form. Please feel free to ask any questions that you may have, and remember that even at this stage, you can decide against going ahead with the procedure if you wish. A small cannula (thin tube) may or may not be placed into a vein in your arm. You will lie on the X-ray table, generally flat on your back. You may have monitoring devices attached to your chest and finger and may be given oxygen. The procedure is performed under sterile conditions, and the interventional radiologist and radiology nurse will wear sterile gowns and gloves. The consultant radiologist will decide where the needle is to be inserted, usually the groin, but sometimes the neck. Your skin will be swabbed with antiseptic, and you will be covered with sterile drapes. The skin and deeper tissues over the vein will be numbed with local anaesthetic, and then a fine tube (catheter) will be inserted and guided, using the X-ray equipment, into position down the vein (testicular vein), which takes blood away from the testis. The interventional radiologist will block this vein, usually by inserting small metal coils, which look like springs and will remain in the abnormal vein. The radiologist will inject small amounts of dye (contrast agent) to check the position of the catheter and that the abnormal veins are blocked satisfactorily. Once they are blocked, the catheter will be removed. The interventional radiologist will press firmly on the skin entry point for a few minutes to prevent any bleeding.
How long will this take?
This examination can take up to an hour; you should be prepared to be in the department for up to 3-4 hours.
After the procedure
Nursing staff will carry out routine observations, including pulse and blood pressure, and will also check the treatment site. You will generally stay in bed for a couple of hours, and then you will be able to go home. Take it easy for the rest of the day, but you can resume normal activities the next day.
Can I drive after my procedure?
No, it is important that you have a responsible adult to escort you home. You must not drive or use public transport for the journey home.
How soon can I return to work?
It is recommended that you rest for the remainder of the day. You must avoid heavy lifting and gym exercise, and you can return back to work after 48 hours.
What do I do if I feel unwell after I have gone home?
You may have a small amount of bruising around the site of entry; however, if you notice any excessive bleeding you should call your GP, or go straight to the A&E department. If you experience a high temperature or fever, excessive pain, or diarrhoea you must contact your GP or the A&E department as you may have an infection which needs to be treated with antibiotics.
Contacting the team
- If you have any further questions about your procedure or an existing appointment, please contact the radiology department (Monday to Friday, 9am to 4pm) at 01279 82 2527 or 3405
- If you have any queries outside of working hours (after 4pm and on weekends), you will be redirected to the main radiology reception. Please note appointment bookings cannot be made during this time.
Your feedback matters
- If you would like to give feedback on your care, please contact our patient experience team at [email protected] or01279 827211.
- Please contact the communications team at [email protected] if you would like this leaflet in another language or format.