Varioceles are dilated veins in the scrotum (similar to varicose veins in the legs), and are thought to develop from abnormalities in the one-way valves present in normal veins. Varicoceles are quite common, being present in about 15-20% of the post-pubertal male population. Small varicoceles typically do not cause problems, but larger varicoceles can cause increased temperatures within the scrotum due to pooling of blood in the enlarged veins. This elevation in temperature, over time, can result in testicular cell damage and decreased sperm counts and quality. Varicoceles are one of the most common cuases of male factor infertility. In properly selected patients, repair of varicoceles can significantly improve sperm numbers and quality in approximately 70% of cases. If left untreated, varicoceles can cause a progressive decrease in sperm quality of time due to the persistent heat effect.
Varicoceles can be treated in several ways. One treatment option is outpatient microscopic surgical repair, in which the dilated veins are carefully ligated (tied off) with the assistance of an operating microscope. The other treatment option is embolization, in which a specially trained radiologist uses a transvenous catheter to permanently block the veins using small metal coils. The choice of treatment is based on individual clinical parameters as well as the personal preferences of the patient.
