Written by – Dr Arpit Taunk (Interventional Radiologist)

The spermatic cord comprises veins, nerves, and blood vessels linking the testicles within the scrotum to the abdomen. Within the healthful veins of the spermatic cord, internal valves facilitate the circulation of blood from the testicles to the scrotum and back to the heart. In cases of varicocele, these valves malfunction, impeding the efficient return of blood to the heart and leading to the accumulation of blood in the vein. Consequently, this condition manifests as an enlarged or swollen testicular vein, commonly referred to as a varicocele.

SYMPTOMS:

• A comforting sensation in the scrotum, particularly noticeable during extended periods of standing, provides a sense of relief and ease.
• Prominently enlarged or uniquely patterned veins (some individuals describe them as resembling a bag of pearls) can be observed.
• Swelling in the testicles
• Tenderness to the touch

WHAT IS VARICOCELE EMBOLIZATION?:

Interventional Radiologists undertake varicocele embolization as a procedure to address issues with a malfunctioning vein. This method is considered less invasive when compared to both traditional open surgery and laparoscopic surgery. Using fluoroscopy (an imaging machine that provides continuous x-ray images) the interventional radiologist inserts a small catheter through a very small incision into the femoral vein, jugular vein, or arm vein. The catheter is then guided into the affected testicular vein. The interventional radiologist proceeds by inserting a compact coil into the vein to obstruct blood flow, or administering a medication that induces the closure of the vein.

This results in the redirection of blood to adjacent, unaffected veins, enhancing the flow efficiency within the scrotum and facilitating its return to the heart. Over several weeks, the body assimilates the addressed vein, leading to its gradual disappearance.

ADVANTAGES OF VARICOCELE EMBOLIZATION

• This procedure uses local anaesthetics combined with IV sedatives rather than general sedation.
• It is a much less invasive procedure since it only involves making a slight incision in the skin and uses imaging guidance to move the catheter towards the enlarged vein.
• The procedure’s minimal invasiveness contributes to a notably reduced recovery period, allowing the majority of patients to return to their regular activities within a day.