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Capital Region Health Park
711 Troy-Schenectady Road
Latham, New York 12110

47 New Scotland Ave
Albany, NY 12208

(518) 262-5149
Fax: (518) 262-4210

 

 

 

Interventional Care - Interventional Radiology

Community Vein Care at Community Care Physicians, P.C.   

Male Infertility Due to Varicocele

Under normal circumstances, blood flows from the testicle to the heart through a network of small veins leading into a vein called the testicular vein.  This blood should flow one-way, from the testicle to the heart and is able to do so because of valves within these veins that prevent the flow of blood back into the testicle.  If these valves fail, then blood flow out of the testicle can become compromised, which can lead to enlargement of the veins surrounding the testicle, also known as a varicocele.  This occurs more commonly on the left than the right due to differences in venous anatomy.

In many patients, varicoceles cause no symptoms.  Some patients may experience testicular pain when standing or sitting for an extended period of time.  Others may develop fertility problems.  While the association of varicoceles and infertility is felt to be somewhat controversial, it is known that patients with varicoceles can have a decreased sperm count and/or decreased sperm motility.  Both of these may be due to an increase in testicular temperature caused by the varicocele.

Diagnosis of a Varicocele

Ultrasound: A testicular ultrasound is often used to diagnose a varicocele.  An ultrasound is a painless, non-invasive test that uses sound waves to directly visualize the abnormal veins surrounding the testicle.  The enlarged veins are easily seen with ultrasound, especially when color flow imaging is performed.

Interventional Treatment of a Varicocele

Testicular Vein Embolization: In this procedure, a catheter (tube) is placed directly into the abnormal testicular vein.  The catheter enters the venous system from the femoral vein or the internal jugular vein.  Once the catheter is within the vein, x-rays are used to guide the catheter into the abnormal testicular vein. 

At this point, an iodine-based dye is injected into the vein and images are obtained to confirm the reversal of flow within the vein.  Small metal coils or plugs are then inserted to block flow into the vein.  This prevents the reversal of flow in the abnormal testicular vein, which reduces the pressure within the veins making up the varicocele. 

This procedure is typically performed as an outpatient procedure, with most patients going home after a few hours of observation and returning to normal activity within 24 hours.

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