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Diğer ameliyatsız tedavilerimiz (Other nonsurgical treatments)

"Most varicoceles can be nonsurgically

treated with embolization"

Prof Saim Yılmaz, MD

  • Do all varicoceles require treatment? If the varicocele causes pain, sperm decrease or deformation, testicular atrophy, bad appearance or leg varicosities, then it generally requires treatment. If there are no such problems treatment may not be needed.

  • Will the sperm number and quality improve after embolization? It has been proved in many studies that correction of varicocele with embolization or surgery would improve sperm number and quality. But the results may differ from patient to patient. The rate of pregnacy after varicocele treatment has been reported to be 30-50% in couples who do not have children due to male infertility.

 

  • Will the pain in the testicle disappear after embolization? After a successful embolization, it is expected that the testicular pain will disappear. If it doesn’t, then other reasons that may cause testicular pain must be investigated.

  • Does embolization have risks? Like any other medical interventions, embolization has also some risks. But they are rare and relatively unimportant compared to those of surgery. After the embolization, bleeding at the skin entry site, nausea and vomiting may rarely develop. The venous blood in the varicocele may be clotted (pampiniform phlebitis) and may cause pain requiring analgesic medications for a couple of days. Except for these uncommon and minor complications, severe side effects are extremely rare. Infection, hydrocele and testicular damage have never been reported.

 

  • Are the coils and foam used in embolization harmful to the body? No, the embolization materials have been used in medicine for decades and no important side effects have been reported.

 

  • Does embolization affect sexual life? No, embolization has no side effects on sexual life.

 

  • Do I receive radiation during embolization? The radiation dose to the testicle during embolization is extremely low, which is about the same as one would receive with a routine chest X-ray.

 

  • Can varicocele recur after embolization? Varicoceles may recur after embolization or surgery. In the literature, the risk of recurrence has been reported to be 5-11% for embolization. If recurrence occur embolization may be safely repeated.

  • Can the varicoceles that recur after surgery be treated with embolization? Embolization is the ideal treatment in such cases. In these patients, recurrence is generally due to ligation of the wrong vein during the surgery; since there is no method that can show the refluxing veins on the operation table, the surgeon ties up the veins that he / she thinks abnormal. If this estimation is not correct, then the varicocele will be untreated. In such a case, the repeat treatment should have the ability to correctly demonstrate the refluxing veins. This can be best done with venography and then the refluxing veins be embolized in the same session.

  • If varicocele embolization is so good why is it not more frequently performed? There may be several explanations; first, the doctors that see varicocele patients first may not have sufficient information about embolization or they may simply prefer surgery since they are also surgeons. That is why, only the patients that like searching become aware of such treatments like embolization. Second, the physicians that can perform varicocele embolization, and the angiography machines, which are different from the coronary angiography, are not available everywhere. Despite that, both situations are rapidly improving and varicocele embolization is becoming a very well-known procedure worldwide.

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