A varicocele is an enlarged, refluxing network of veins in the scrotum — essentially a varicose vein in an unusually inconvenient location. They occur in roughly fifteen percent of men, far more often on the left, and many cause no trouble at all.
When they do cause trouble, it shows up in three ways. The first is discomfort: a dull, dragging ache that builds through the day, worsens with standing or exertion, and eases when lying down. The second is testicular atrophy, particularly in adolescents, where the affected testicle grows more slowly than the other. The third is fertility — varicoceles are the most commonly identified and most commonly correctable cause of male-factor infertility, and correcting them can improve semen parameters.
Surgical repair through a groin incision is the traditional treatment. Embolization achieves the same goal from inside the vein. A catheter is guided from a vein at the neck or groin down into the refluxing spermatic vein, and that vein is closed with coils or a sclerosing agent. Blood immediately reroutes through normal channels. There is no incision, no general anesthesia, and no risk of injury to the artery or the vas deferens from operating in the groin.
What the procedure involves
Ultrasound confirmation
A scrotal duplex ultrasound confirms the varicocele, grades it, and documents reflux.
Venous access
Under local anesthesia and light sedation, a catheter enters a vein at the neck or the groin — the venous system, not the artery.
Mapping and closure
Contrast shows exactly where the vein is refluxing. Coils, plugs or a sclerosing agent are placed to close the refluxing channel and any collaterals feeding it.
Home in a few hours
Pressure is held at the puncture site. Most men leave within a couple of hours and are back at desk work the next day.