Varicocele Treatment

In most cases, varicoceles treatment is not necessary. Most men with varicoceles do not experience fertility issues. However, if the condition is causing pain, testicular atrophy, or infertility, you can benefit from varicoceles treatment. The treatment helps in sealing off the affected vein and redirecting the blood flow into normal veins. In case of infertility issues, varicoceles treatment helps in improving the quality of the sperm and sperm count. The procedure that we perform at LA Jolla Vein & Vascular on varicocele is percutaneous embolization or varicocele embolization.

The primary goal for varicocele treatment procedures is to help prevent the backflow of blood from the body to the scrotum, helping in cooling off the testes. Surgical procedures will help restrict the blood flow to the veins leading from the testis to the body. However, not all the veins are sealed off. The vassal vein, which is not subject to the same problems as the other varicose veins, is left open to allow blood to leave the testicles after the procedure.

Some of the clear indications that you need varicoceles repair during adolescence include pain, progressive testicular atrophy, and abnormal semen analysis results. While this treatment helps in improving sperm characteristics, it is not clear whether untreated varicoceles can lead to progressive sperm worsening. The common varicoceles treatment options include (La Jolla Vein & Vascular Only Performs Varicocele Embolization):

Percutaneous Embolization (Varicocele Embolization)

Percutaneous embolism is an advanced procedure performed by a radiologist. The specialist usually makes a small cut into a vein in the groin and inserts a tube. The doctor will use X-ray imaging to guide them to the affected veins and insert a coil or a balloon into it through the tube. The procedure helps in blocking the blood flow to the varicocele, shrinking it gradually. This procedure is also done with general anesthesia.

Catheter-directed Embolization

Catheter-directed embolization is a non-surgical, outpatient treatment performed by an interventional radiologist using imaging to guide catheters or other instruments inside the body. Through mild IV sedation and local anesthesia, patients are relaxed and pain-free during the approximately two-hour procedure.

For the procedure, an interventional radiologist makes a tiny nick in the skin at the groin using local anesthesia, through which a thin catheter (much like a piece of spaghetti) is passed into the femoral vein directly to the testicular vein. The physician then injects contrast dye to provide direct visualization of the veins so he/she can map out exactly where the problem is and where to embolize or block the vein. By using coils, balloons, or particles, the interventional radiologist blocks the blood flow in the vein, which reduces pressure on the varicocele. By embolizing the vein, blood flow is re-directed to other healthy pathways. Essentially, the incompetent vein is “shut off” internally by preventing blood flow, accomplishing what the urologist does without surgery.

Efficacy of Embolization for Varicoceles

Embolization is equally effective in improving male infertility and costs about the same as surgical ligation. Pregnancy rates and recurrence rates are comparable to those following surgical varicocelectomy. In one study, sixty percent conceived were treated for infertility.

In another study, sperm concentration improved in 83 percent of patients undergoing embolization compared to 63 percent of those surgically ligated. Patients who underwent both procedures expressed a strong preference for embolization.

Varicocelectomy

Your doctor will make a small 1-inch incision into your scrotum and use a microscope or magnifying glass to see the veins better. The doctor might use local anesthesia to numb the area. General anesthesia can also help you sleep through the procedure.

Laparoscopic Surgery

This procedure involves making a much smaller incision and inserting a tube that holds the surgical tools. The surgeon will also use a special camera to see inside you. The procedure is done under general anesthesia to help you sleep through the procedure. The results from the other treatments are similar, only that the incision is small with laparoscopic surgery.

Open Surgery

The open surgery treatment is usually done on an outpatient basis and using a local or general anesthetic. The surgeon will make a small incision below your groin or abdomen to access the affected vein. Your doctor uses advanced surgical tools such as Doppler ultrasound and a surgical microscope to help guide the procedure. The patient can return to a regular daily routine after two days.

Recovery

In most cases, you can go back to your routine after two days of varicose treatment. However, it is advisable to take it easy. Avoid strenuous activates and exercise for about two weeks.

People who have undergone percutaneous embolization tend to recover faster. While you may need a day or two off from work, you can return to your workout program in 7-10 days. If the treatment procedure is to help with fertility, your doctor will perform an additional test in 3-4 months. You will be able to see improved results in 6-12 months. It is important to note that more than 50 percent of men who have undergone the procedure have restored their fertility. Additionally, these surgical procedures are also crucial for teens as they help in slowing testicular growth.

OUR PATIENTS SAY

Dr De Young is personable and thorough in his explanations. Exceptional.

James R.

I am pleased to recommend La Jolla Vein & Vascular. I am in the process of receiving treatment there. The entire medical staff are super friendly, welcoming and very helpful. Everyone is courteous, including the physicians. I’ve had one doctor follow my case. He’s the one who always treats me at appointments and closely follows my health. I am very comfortable going there. Would go again if needed and encourage anyone who’s thinking of making an appointment to do so asap. You’ll see what a wonderful experience it is. It’s the people who make it so special!

Monica M.

From my greeting at the front desk to the ultrasound and visit with the doctor, I received excellent care. It’s clear they care about their patients and all the staff couldn’t have been nicer or more helpful. I also appreciate how much time the doctor spent with me to explain the results and the next steps. I would definitely recommend this office to friends with vein issues.

Anne S.

We were early and didn’t have to wait at all. The tech that did my husband’s ultrasound, Monica, was very accommodating with my husband’s Parkinson’s. Doctor Lucas whom we hadn’t seen before, came to us instead of making my husband walk down to another office. She spent a lot of time getting caught up on Steve’s background issues/conditions. I was impressed by this medical group before, so I was surprised that the staff was even better this time around; I honestly didn’t think there was room for improvement!

Linda N.

I have been having leg treatments for several months now La Jolla Vein Care. Every time I go to an appointment; the staff is so friendly and takes such good care of me; always informative; not in a rush and always friendly (especially Alejandra & Anna to name a few). Of course Dr. Lucas is amazing. The treatments have changed my life. Overall this has been an incredible experience.

Brigid Z.

Beautiful facility! I walked in without an appointment and they took me right away! It was even the end of the day…I was so grateful…Every single person was soooo pleasant! Super impressed ❤️

Susan M.

Highly recommend! Entire staff are warm& friendly, professional and accommodating. The doctor took the time to thoroughly explain everything and encouraged me to ask questions. I never felt rushed. Significantly better experience than the other 2 vein clinics I’ve been to on the east coast. I wish I could’ve just come here from the beginning.

The staff kept you informed as to when you would be seen and the wait was not too long. Emily took care of my ultrasound and was very accommodating giving me an extra pillow and playing a video to watch. The office is very courteous and professional- Nadia answered our questions and offered us a bottle of water. I have been seeing Dr. Bunke, but now Dr. Lucas and will continue coming to La Jolla Vein Care!

Rebecca D.

I had the best experience at La Jolla Vein Care. Dr.Bunke is an amazing doctor with the best bedside manners, she truly cares about her patients, she explained everything to me. My procedures where so easy I was impressed how painless and fast my appointments. Anna M was very helpful scheduling my treatments and checking on me to make sure all of my questions were answered. I am very pleased thank you !!! I truly recommend La Jolla Vein Care!

Henda S.

Everyone here is so nice! Usually front desk medical personnel are so rude. The front desk ladies Alejandra, Anna, and I think her name is Liz, went above and beyond to take care of me and my insurance issues. The techs are great too! Rachel and a male technician assisted me…both of them implemented different techniques to make me feel more at ease during an uncomfortable and painful process. These procedures were rough…and I am grateful everyone was so sweet to me. Thanks again.

Melissa B.

When I arrived for the first time, I could barely walk. My legs were red and swollen. After my treatments, I can now walk again. I’m so thankful to the doctor and his staff. They are caring, supporting and knowledgeable about my issues. Five Stars all the way!!!!

Pamela M.

La Jolla Vein care has the best staff ever. They are so nice, accommodating and professional!! Dr. Bunke is the best doctor that I ever seen. She is so friendly upfront and has the best bed side manner. I thank this office for letting me be their patient. 💜. Plus they are so careful with COVID which I really appreciate!!!

Darlene H.