This page tells you about the procedure known as varicocele (pronounced VARI-CO-SEAL) embolisation. It explains what is involved and what the possible risks are. It is not meant to be a substitute for informed discussion between you and your doctor, but can act as a starting point for such a discussion.
Your procedure will take place in the Radiology department. The radiology department may also be called the ‘X-ray’ or ‘Imaging’ department. It is the facility in the hospital where radiological examinations are carried out, using a range of x-ray equipment, such as a CT (computed tomography) scanner, an ultrasound machine and a MRI (magnetic resonance imaging) scanner.
Interventional Radiologists are doctors specially trained to carry out imaging guided complex procedures. They are supported by radiographers who are highly trained to carry out x-rays and other imaging procedures. Also specialist nurses who are highly trained in interventional procedures, sedation, recovery and patient support.
A varicocele is an abnormality of the veins that take blood away from the testicle. The veins become bigger and more obvious, rather like varicose veins in the leg. Embolisation is a way of blocking these veins, and therefore making them less obvious and causing the varicocele to disappear, without an operation.
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 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 3–4 mm incision in the groin. It is performed as a day case 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 afterwards which rarely lasts more than a few days.
There is a very small risk of a coil, used to occlude the vein, could migrate 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.
You need to be come to the Imaging Department at the time instructed on your appointment letter. You may be asked not to eat for six hours before your appointment time, though you can continue to drink clear fluids up to two hours prior to your appointment.
On arrival you will be checked into the department by a nurse. The nurse will fill in some paperwork and do some clinical observations-like blood pressure and pulse. The Radiologist will come and explain the procedure and sign off the Consent form with you. This is where you have the opportunity to talk to the Radiologist doing your procedure and they will be able to address any concerns you may have.
You will be asked to put on a hospital gown. The procedure is carried out using the big vein in the neck. (Very occasionally a large vein in the groin is used instead. If this is the case, you will be informed. The skin in this area may have to be shaved.)
This procedure is usually performed under local anaesthetic or light sedation. If sedation is required during the procedure, you must have an escort arranged to take you home and stay with you overnight so please ensure these arrangements are made.
If you have any allergies, you must let your doctor know. If you have previously reacted to intravenous contrast medium (the dye used for kidney x-rays and CT scans), then you must also tell your doctor about this.
We want to involve you in all the decisions about your care and treatment. If you decide to go ahead with procedure, by law we must ask for your consent and will ask you to sign a Consent form. This confirms that you agree to have the procedure and understand what it involves.
The consent form is a form that both you and the operating doctor sign confirming that you have discussed the procedure and been informed of the risks/benefits/alternatives and have agreed to carry on with the interventional procedure. (You can have a copy of this form to take with you.)
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 so wish.
You will lie on the X-ray table, generally flat on your back. A needle will be inserted into a vein in your arm, so that a sedative or painkillers can be given if required (This is generally not needed as the procedure is usually tolerated very well with just a local anaesthetic). 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 skin near the point of insertion, usually the neck, 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.
Some discomfort may be felt in the skin and deeper tissues during the injection of the local anaesthetic. After this, the procedure should not be painful. There will be a nurse, or another member of clinical staff, standing nearby looking after you. If the procedure does become uncomfortable, they will be able to arrange for you to have a painkiller through the needle in your arm. As the dye, or contrast medium, passes around your body, you may get a warm feeling, which some people can find a little unpleasant.
Every patient’s situation is different, and it is not always easy to predict how complex or how straightforward the procedure will be. Generally, the procedure will be over in about an hour.
You will be taken to the recovery area on a trolley. A recovery nurse will carry out routine observations, such as taking your pulse and blood pressure, to make sure that there are no problems. They will also look at the skin entry point to make sure there is no bleeding from it.
You will generally stay in bed for about an hour, until you have recovered. The nurses will let you know when they are happy for you to be discharged from recovery. You will be allowed to go home after this but will need someone to escort you. You will need to take it easy for the rest of the day but you can resume normal activities the next day.
The Radiologist will talk to you after the procedure and will write a detailed report on the findings straight afterwards. This written
report will be available to your referring doctor. The referring doctor may make a follow-up appointment for you in clinic to see your consultant after you have this procedure.
Some of your questions should have been answered by this page but remember that this is only a starting point for discussion about your treatment with the doctors looking after you. Make sure you are satisfied that you have received enough information about the procedure.
Contact:
British Society of Interventional Radiology
For health advice or information you can call NHS Direct on 0845 45647.
NHS Clinical Knowledge Summaries
UCL Hospitals cannot accept responsibility for information provided by other organisations.
Tel Number: Interventional Radiology Clinical Nurse Specialist: 07374 875 629
UCH Switchboard: 020 3456 7890
Address:
Interventional Radiology Imaging Department
University College Hospital
2nd Floor
235 Euston Road
London
NW1 2BU
Radiology email: uclh.
Radiology Admin enquiries phoneline: 020 3447 3267
Website: www.
Hospital Transport Services: 020 3456 7010
Procedures:
The Imaging Department, Level 2 Podium in the main University College Hospital building with the entrance on Euston Road (see map below).
Travelling to the hospital
No car parking is available at the hospital. Street parking is limited and restricted to a maximum of two hours.
Please note the University College Hospital lies outside, but very close to the Central London Congestion Charging Zone.
Tube
The nearest tube stations, which are within two minutes’ walk are:
- Warren Street (Northern and Victoria lines)
- Euston Square (Hammersmith & City, Circle and Metropolitan lines)
Overground trains
Euston, King Cross & St Pancras and Kings Cross Thames link railway stations are within 10-15 minutes’ walk.
Bus
Further travel information can be obtained from the TFL website or you can call 020 3054 4040.
Hospital transport service
If you need (and are eligible for) transport, please call:
020 3456 7010 (Mon to Fri 8am-8pm) to speak to a member of the Transport Assessment Booking Team.
If you have a clinical condition or mobility problem that is unlikely to improve you will be exempt from the assessment process. However, you will still need to contact the assessment team so that your transport can be booked. If your appointment is cancelled by the hospital or you cannot attend it, please 020 7380 9757 to cancel your transport.
University College Hospital Area Map
Services
Page last updated: 31 October 2024
Review due: 01 March 2026