Varicoceles are abnormally enlarged veins within the scrotum and around the testicles. They are caused by leaky valves within the veins through which blood circulates from the scrotum back to the heart. Normally these valves prevent blood from flowing backwards into the scrotum. When the valves are faulty, blood flowing backwards fills and enlarges the veins within the scrotum. Varicoceles most commonly occur around the left testicle.

Varicoceles can cause an aching type of pain in the scrotum. They are also a common cause of infertility. In fact, 40% of patients with decreased fertility have a varicocele. Varicoceles appear to cause decreased fertility by raising the temperature within the testicle which then leads to decreased sperm production and the production of abnormal sperm. In adolescents, varicoceles can also cause atrophy (shrinkage) of the testicle.

Varicoceles are often diagnosed with a simple physical exam. The affected side of the scrotum will have the appearance of a "bag of worms" and will often lie lower than the normal side. The most accurate way, however, to diagnose a varicocele is an ultrasound exam. This study will show the enlarged veins and will demonstrate the "backwards" flow of blood.

A varicocele which does not cause pain, fertility problems or atrophy does not necessarily need to be treated. In the past, when a varicocele did cause one or more of these problems the traditional treatment was surgery. This surgery, which is usually performed by a urologist, involves making an incision just above the scrotum. The veins are then tied off to stop the abnormal, backwards flow of blood into the varicocele. Recovery from this surgery can take weeks and there is a significant risk of complications such as infection and hydrocele (fluid build-up in the scrotum)

At Valley Endovascular, we utilize a less invasive approach. Through a tiny hole in the skin in the groin, we insert a catheter (a tube the size of a strand of spaghetti) into a vein. Then, using an x-ray guidance system, we guide the tip of the catheter into the the vein (the internal spermatic or testicular vein) which contains the abnormal valve which is the cause of the varicocele. Metallic coils are then placed into this vein through the catheter. This blocks the abnormal flow of blood into the varicocele. Following the procedure there are no stitches, patients leave the hospital the same day, and most patients can return to regular activities the following day. Varicocele embolization has been shown to be as effective as surgery and carries a lower risk of complications.

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