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, we can help. Treatment involves 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 is called varicocele embolization.

The primary goal for varicocele treatment is to help prevent the back flow 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.

What are the symptoms of a varicocele?

Many times a varicocele is silent and does not cause symptoms. However, some varicoceles cause a dull or aching pain, especially when the person has been in an upright position for a long time. Heavy lifting may also cause pressure build up in the varicocele.

In some individuals, a varicocele may cause decreased fertility or infertility. As many as 40% of men with decreased fertility have a varicocele. A commonly accepted theory is that the varicocele raises the testicular temperature and adversely affects the sperm count and quality. More than half of men with decreased fertility will have improvement in the sperm count and quality after treatment of the varicocele.

In some men, varicoceles can cause shrinking (atrophy) of the testicles. In many cases, when the varicocele is treated on the affected side, the testicle may return to normal size.

How is a varicocele diagnosed?

It is best to catch a varicocele before it can cause major problems, such as infertility. Self-exam of the scrotum is the best way to diagnose a varicocele early. A varicocele can feel like a “bag of worms”, and is usually found in the left testicle. Our specialists can diagnose a varicocele with a physical examination in most cases.

Do I need to be treated?

If the varicocele does not cause any symptoms or infertility, it may not need to be fixed. However, if there is associated pain, decreased fertility, or testicular shrinking, treatment may help. Adolescents with varicoceles should be treated to avoid future infertility.

Some of the clear indications that you need varicoceles repair include pain, progressive testicular atrophy, and abnormal semen analysis results.  The common varicoceles treatment options include:

Varicocele Embolization

We use a procedure called varicocele embolization to treat testicular varicose veins (varicocele).  With this procedure, there are no stitches or general anesthesia and only a 1/4 of an inch incision. Nearly all the patients can be treated on an outpatient basis and may return to normal activities in two to three days. Surgical treatment requires an incision and may require several days or even weeks to return to full activities. Studies have shown that embolization and surgery are equally effective.

Regardless of the treatment, the varicocele may recur and may require repeat treatment. If the varicocele has been previously treated with surgery, embolization is still an option. If the varicocele recurs after the embolization, embolization can generally be repeated. If a repeat embolization fails, surgery can still be performed.

How is the embolization procedure performed?

Varicocele embolization is usually performed on an outpatient basis under sedation and local anesthesia. A small catheter (tube) is inserted into a leg vein near the groin through a tiny skin incision. This tube is placed into the varicocele vein under X-ray guidance. Small amounts of X-ray dye (contrast) are injected to confirm the position of the catheter. Then, tiny coils made of stainless steel or platinum, balloons, or other materials are inserted in the vein. They are used to block it and stop the backflow, or pressure, in the varicocele. Blood can still exit the testicle through other normal pathways. Once it is confirmed that there is no flow in the affected vein, the catheter is removed.

How well does embolization work?

There is a 90% success rate with embolization, and of those with success, about 10% may experience late recurrence. These results are the same as those achieved with more invasive surgical techniques. Varicocele embolization has been performed for over 25 years and has an excellent long-term safety record. Its safety and effectiveness has been shown in very large trials.  Embolization is equally effective in improving male infertility and costs about the same as surgical ligation.

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.

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.

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.


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


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.

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. 


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.

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

James R.

The staff members that I interacted with were all professional, conscientious and empathetic to my complaints and discomfort. I was taken into the ultrasound room a few minutes before my appointment time. I did not have a long wait before the ultrasonographer came and ran the machine. It was also a short wait before Dr. Steinburg came into the room with a warm, welcoming smile. We discussed my ultrasound and the things I was experiencing . I scheduled another appointment for next year and was offered a bottle of water upon leaving the office. All in all, I thought it was a very satisfactory appointment.

Renee P.

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.

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.

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.

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.

The office is exceptional, from front desk, to exam staff to the physicians. They have created a welcoming, relaxing environment, and take their time in examining and consulting with you to provide the best outcome. I highly recommend La Jolla Vein & Vascular for the assessment and treatment of your vein and vascular function.

Nancy F.

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.

The staff at La Jolla Vein Care Center are outstanding. They are friendly and helpful. Dr. Lucas and my ultrasound tech were both very thorough, kind and answered all of my questions. The new office was beautiful. I feel very confident that I am in good hands and that any up coming treatments will be successful. Thank for for making me feel so comfortable.

Ginger T.

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.

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