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Varicocele, a common disease that occurs in 10~15% of men.
Treated with ‘varicocele embolization’, a safe and effective non-surgical treatment

Varicocele
Double embolization that flawlessly blocks causative blood vessel and full-scanning technique, the standard of varicocele treatment.

What is varicocle


Varicocele is a vascular disease of scrotal (sac that covers testicles) vein convoluted due to blood stagnated by abnormal venous valve which interrupts blood from flowing back to heart.

It has similar pathology as varicose vein and differs in that the location is not leg, but scrotum (95% or more occurs in left scrotum). It may be rare, but it is common as 10~15% of men has it.

    • Varicocele confirmed in 35%
      of men with infertility

    • Increased number and motility
      of sperms after treatment

    No. 1 cause of male infertility

    Varicocle and infertility are deeply related. According to research, if the husband in a couple who have not been successful to have a child for a year without special reason has varicocele, natural pregnancy rate has increased significantly once treated.
    However, there is still ongoing research on their correlation and there are two hypotheses that can explain the mechanism.

    How varicocele induces infertility

    • Hypothesis 1
      Accumulation of waste in scrotum due to regurgitation of blood > damage to testicle due to active oxygen
    • Hypothesis 2
      Rise in testicle temperature due to collection of blood > Interruption of spermatogenesis
      (Less sperm motility and count)

  • World Health Organization (WHO) recommends
    that men take varicocele tests during adolescence after 10.

    From adolescence to adult and elderly,
    varicocle that any men can have Early dianogsis’ is the best preventive measures.

    Varicocele usually develops around puberty and can affect testicular growth and function. It is a progressive disease that is not healed naturally and lasts forever.
    Nevertheless, most patients live without its knowledge as it is painless.
    However, if varicocele is left untreated, testicular function gradually deteriorates, posing as the cause of infertility. This is why many patients visit hospital in late stage after learning about the disease while trying to have a baby

    Therefore, any parents with a boy must have proper understanding of varicocele and have their child have early screening (palpitation and doppler ultrasound) from elementary school. Also, genetics play a major role in varicocele, so anyone with family history must have more aggressive tests and close monitoring.


Diagnosis of varicocele

It is mostly congenital, so early finding and treatment is the best treatment.

  • Self-check

    ※ When your scrotum is sagging after taking a warm shower, check the following. If you can identify any of the following, please see a specialist.


    • ① Seen with bare eyes
      • · Great difference in size of testicles.
        (Mild difference is normal)
      • · Too sagging of scrotum
      • · Convoluted vessels around scrotum
    • ② When touching your testicles with both hands while tightening your abdomen
      • · Palpable blood vessels in testicle
    • ③ Pain and dull discomfort in testicle when standing for long period.
    • ④ Occasional hot sensation

  • Interview / Physical examination

    When examined with the patient standing up, it can be classified into stage 1~3 depending on the distention of vein


    • Stage 1
      palpable when tightening your abdomen as if you are coughing
    • Stage 2
      palpable when standing still
    • Stage 3
      Convoluted vessels with naked eyes

  • Doppler ultrasound

    Precise diagnosis can be obtained as it can acquire anato It is performed to rule out any other diseases like hernia or epididymitis after palpitation.

    Pelvic ultrasound (left) and Doppler ultrasound (right) in patient with varicocele Doppler ultrasound can produce image in color, showing the regurgitation in red.

  • Infrared body
    temperature measurement

    By detecting infrared from human body, the area with worst blood flow stagnation is depicted in red, allowing to clearly differentiate site of varicocele

  • Sperm test

    If you are planning to have a baby, it is recommended to take one. After taking your semen, the test confirms sperm count, motility, and deformity. There may be difference depending on your daily conditions like drinking on previous day or fatigue and if the result is not so great, it is recommended to take the test again 2~3 times.

  • Venography

    It is the most accurate method, but it is invasive (penetrates skin) and requires the best technique, so it is conducted only for special circumstances.

Treatment

Conventional surgical treatment

Open surgery that makes incision in groin (margin between abdomen and thigh) or laparoscopic surgery via umbilicus resect the affected vein.
It takes some time for recovery and there may be complications, such as hydrocele (Watery collection in testicle) or
testicular atrophy due to testicular artery damage.


MINT hospital performs the safe
and effective non-surgical treatment of ‘varicocele embolization’.

Varicocele embolization

It is a non-surgical intervention treatment that inserts long medical catheter into blood vessel in right arm or thigh to occlude the vein and prevent regurgitation.
Intravascular procedure is safe and shows great result as it does not irritate any surrounding tissues other than the lesion, making it more favorable for patients. Moreover, recovery is rapid as it does not exhaust body and daily life is possible right after the procedure.
Also, advances in monitoring imaging technique and embolization agent, it can be safely performed on adolescents with thin blood vessel and elderly who are difficult to have surgery.



  • Operation duration
    20 minutes
  • No general
    anesthesia
  • No incision
    with knife
  • Almost
    no pain
  • Return to daily life
    after the procedure
  • Safe for adolescents
    and elderly

Treatment of varicocele

Aftercare

You can take shower from the day after the procedure.
You must avoid any extreme physical activity, using abdominal muscle, lifting heavy items, and riding bicycle for next 2 weeks.

Varicocele embolization vs surgery

Varicocele embolization

Technique that blocks regurgitation by occluding vein with platinum coil and sclerotic agent via blood vessel in right arm while monitoring ultrasound and venography video in real time.

 Treatment

Surgery

Technique to stop regurgitation by resecting and tying vein with an incision between lower abdomen and thigh or laparoscopic surgery.

0.2~0.3cm Incision 2.5~3cm
Local anesthesia in arm Anesthesia Spinal anesthesia or lower body anesthesia
20 minutes Operation duration 60 minutes or longer
Almost none Pain ★★★
Almost none Side effect after treatment Risk of hydrocele (water collection in testis)
and testicular artery damage (0.9%)
2~3% or less Recurrence About 9~15% (Naked eye surgery)
Less than 2%(microscope surgery)
Hospitalized for 6 hours Hospitalization At least 3 days
From the day of procedure (Shower is allowed for the next day) Return to daily life after 2 weeks (shower is allowed after 1 week)
2 weeks Days to be able to perform extreme physical activity 4 weeks

Recurrence
after varicocele embolization

Analysis on therapeutic outcome after varicocele embolization

1751cases


After following 1751 patients who had varicocele embolization from 2008 to 2015 in MINT hospital




  • After following 1574 patients
    who were adults among 1751 patients,
    the procedure was successful in 98.5%

  • Among 1540 patients
    who had successful surgery,
    34 (2.3%) showed reccurence



Varicocele embolization
is not effective as much as surgery?

Technical difficulty poses more risk of complication?


The problem proposed above is not true.
Recent varicocele embolization has more excellent outcome unlike the past thanks to advances in angiography, catheter, and embolization agent.

Especially,
MINT hospital conducts a treatment that initially blocks the vein with varices with platinum coil to prevent recurrence and increase accuracy of procedure and injects sclerotic agent (STS, Sodium, Tetradecyl) as secondary measure to occlude the vein once more.
Such double occlusion blocks multiple blood vessels and capillaries with varices simultaneously, significantly decreasing recurrence.
Also, embolization does not irritate surrounding tissue due to intravenous approach, causing much less complication.

Opening Hours

  • Weekdays
    AM 8:30 - PM 5:30
  • Saturday
    AM 9:00 - PM 1:00
    service without lunch time
  • lunch time
    PM 12:30 - PM 1:30

Closed on Sunday & National Holidays.
Opening hours can vary for each medical staff, so please confirm before visiting our hospital

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