Treat a varicocele without surgery
A varicocele is a group of enlarged veins above the testicle that can cause aching and affect fertility. Varicocele embolization closes these veins from the inside through a pinhole in a vein. There is no incision in the groin or scrotum, and you go home the same day.
Call to book: 737-241-2184 How embolization worksWhat is a varicocele, and how does embolization help?
Blood leaves each testicle through a vein called the gonadal (testicular) vein, which has one-way valves that keep blood flowing up toward the heart. When these valves fail, blood flows backward and pools in the network of veins around the testicle. These veins swell, much like varicose veins in the legs.
Varicoceles are common and occur most often on the left side. Many cause no problems. In some men, the pooled blood causes aching, and the extra warmth and pressure can affect sperm production.
Embolization closes the faulty gonadal vein from the inside, above the testicle. Blood then drains through other, healthy veins, the swelling settles and the testicle is no longer exposed to backward flow.
Who is a good candidate?
Embolization has an established role in treating varicoceles in men.3 It is often a good fit if you:
- Have scrotal aching or heaviness from a varicocele that affects your daily life.5
- Are trying to conceive and have a varicocele that can be felt on exam, together with abnormal semen results. The AUA/ASRM guideline recommends that repair be considered in this situation.1
- Want to avoid surgery, an incision or general anesthesia, and return to work quickly.
- Have a varicocele that came back after previous surgery.4
How we decide whether embolization is right for you
We work closely with Urology Austin, so you get a full urological evaluation and an interventional radiology opinion in one place.
Consultation & exam
We review your symptoms and plans for a family, and examine you lying down and standing, since varicoceles are easiest to feel when you stand.
Scrotal ultrasound
Ultrasound confirms the enlarged veins and the backward blood flow, and measures the size of both testicles.
Semen analysis
If fertility is a concern, a semen analysis before treatment gives a baseline to compare against afterward.
How embolization compares with other options
Both embolization and surgery treat the same problem: the faulty veins. The right choice depends on your anatomy, your goals and your preferences.
| Option | How it works | Things to know |
|---|---|---|
| Watchful waiting | Supportive underwear and pain relievers | Reasonable for varicoceles that cause no pain and no fertility problems |
| Microsurgical varicocelectomy | The veins are tied off through a small incision in the groin, using a microscope | Lowest recurrence rate in studies (about 1%); needs anesthesia and an incision6 |
| Laparoscopic surgery | The vein is tied off through small incisions in the abdomen | Requires general anesthesia6 |
| Varicocele embolization | The faulty vein is closed from inside through a pinhole in a vein | No incision, light sedation, same-day discharge, quick return to work; recurrence is somewhat higher than after microsurgery4,6 |
What happens during varicocele embolization
Varicocele embolization typically takes about an hour. You are awake but relaxed, and nothing is done to the groin or scrotum itself.
Preparation
You receive light sedation and local anesthetic at the access site. No general anesthesia is needed.
A pinhole in a vein
A thin tube (catheter) is placed into a vein in your upper thigh or neck through a tiny puncture. No incision is made.4
Mapping the veins
Using X-ray guidance and contrast dye, the catheter is steered into the testicular vein to confirm the backward flow and show any side branches.
Embolization
Small coils, often combined with a medication that seals the vein (sclerosant), are placed to close the faulty vein and its branches.4
Recovery
The catheter is removed and a small dressing applied. You rest for 30 to 60 minutes and go home the same day.
Results
Embolization has been used to treat varicoceles since the late 1970s.3
Technical success in 225 men treated over 15 years, with complications in under 2% and none major.4
Men treated for varicocele pain reported less pain afterward, and about half no longer needed pain medication.5
Pregnancy rates after varicocele treatment, compared with about 21% without treatment, in a Cochrane review of randomized trials.2
Sperm take about three months to develop, so semen tests are usually repeated a few months after treatment. Varicoceles can come back after any treatment: in the 15-year series, ultrasound confirmed a recurrence in about 6% of men who were followed up, and a repeat procedure is often possible. The Cochrane review found that the evidence on pregnancy is of low certainty, and that it is uncertain whether treatment increases live births.2,4 Individual results vary, and no treatment can guarantee success.
Risks and side effects
Varicocele embolization has a low complication rate.4 We discuss all risks with you in detail beforehand:
- Mild ache in the back, flank or groin for a few days
- Bruising or tenderness at the puncture site
- Inflammation of the treated vein, which can cause temporary tenderness above the testicle
- Rarely, a coil moving out of position
- Reaction to contrast dye or sedation
- The varicocele coming back, which may need repeat embolization or surgery4,6
- Occasionally, the vein cannot be reached, which is more common on the right side; surgery remains an option if this happens
Frequently asked questions
Is the procedure painful?
It is performed under local anesthesia with light sedation. Most patients feel only the small needle at the access site. A mild ache for a few days is common.
How soon can I go back to work?
Most men return to work and light activity within a day or two. Your physician will give you specific instructions about exercise, lifting and sexual activity.
When will I know if it has improved my fertility?
Because sperm take about three months to develop, a repeat semen analysis is usually done a few months after treatment.
Will it affect my testicle or hormones?
No. Embolization closes only the faulty vein above the testicle. Blood drains through other healthy veins, and the testicle's arterial blood supply is not touched.
Can both sides be treated?
Yes. If there is a varicocele on both sides, both veins can usually be treated in the same procedure.
Is it covered by insurance?
Coverage varies by policy. We will navigate out-of-pocket costs with you. Call us at 737-241-2184 with questions.
Find out whether varicocele embolization is right for you
If a varicocele is causing pain or may be affecting your fertility, an evaluation can show whether embolization is a good option.
Call 737-241-2184 to scheduleReferences
- Schlegel PN, Sigman M, Collura B, et al. Diagnosis and treatment of infertility in men: AUA/ASRM guideline part II. Fertil Steril. 2021. doi:10.1016/j.fertnstert.2020.11.016
- Persad E, O'Loughlin CAA, Kaur S, et al. Surgical or radiological treatment for varicoceles in subfertile men. Cochrane Database Syst Rev. 2021;4:CD000479. doi:10.1002/14651858.CD000479.pub6
- Ierardi AM, Biondetti P, Tsetis D, et al. CIRSE standards of practice on varicocele embolisation. Cardiovasc Intervent Radiol. 2023;46(1):19–34. doi:10.1007/s00270-022-03293-x
- de Grae MNM, Al-khattab M, Alkadhimi A, et al. A fifteen-year retrospective analysis of varicocele embolization: evaluating success, recurrence rates and embolic agents. CVIR Endovasc. 2025;8:59. doi:10.1186/s42155-025-00575-6
- Muthuveloe DW, During V, Ashdown D, et al. The effectiveness of varicocele embolisation for the treatment of varicocele related orchalgia. SpringerPlus. 2015;4:392. doi:10.1186/s40064-015-1177-2
- Çayan S, Shavakhabov S, Kadioglu A. Treatment of palpable varicocele in infertile men: a meta-analysis to define the best technique. J Androl. 2009;30(1):33–40. doi:10.2164/jandrol.108.005967
This page provides general information and does not replace a personal medical consultation. Study results describe groups of patients and cannot predict the outcome for an individual. Urology Austin and IR Centers · 8701 N. Mopac, Suite 100, Austin, Texas 78759 · 737-241-2184