Can Varicocele Recur After Embolization? Causes & Solutions

Varicocele embolization is a safe and minimally invasive procedure to treat varicoceles-enlarged veins in the scrotum that may cause male infertility-pain-discomfort. It works by blocking the faulty veins and allowing blood circulation through healthier veins improving the quality of sperm. But another common concern-that troubles hundreds of men undergoing this treatment-is: can a varicocele recur after embolization?

The answer is yes, though it's rare. Although embolization has a high success rate, there remains the possibility for a varicocele to return or recur. Following are some points concerning the natural history of this condition, how frequently it occurs, and preventive or curative options.

Why Can Varicocele Return After Embolization?

There are several possible mechanisms for the recurrence of a varicocele after embolization:

Incomplete Closure of Faulty Veins: During the embolization procedure, the enlarged veins are occluded by the doctor with tiny coils or a medical adhesive-like substance. If some tiny branches of the abnormal veins remain patent, the blood may still flow abnormally through them, leading to reappearance of the varicocele.
Development of New Vessels (Collateral Circulation): In some cases, the body may establish new veins to bypass those blocked. If these newly instituted veins also enlarge, varicocele may return.
Technical Considerations: During embolization, some abnormal veins can be visualized under fluoroscopy. In instances where not all the abnormal veins are seen during the procedure, treatment may be incomplete and result in recurrence.
Anatomy-Underlying Medical Pathologies: There may be some men who have varying anatomic configurations or disorders that would render them more prone to a recurrence.

How Common Is Varicocele Recurrence?

Studies show varicocele recurrence after embolization occurs in about 5-10% of cases. This is comparable to the recurrence rate after traditional surgical treatment (varicocelectomy). However, the good news is if necessary, the embolization can be repeated and result in a high rate of success.

Things That May Indicate The Return Of A Varicocele

Recurrence of a varicocele could lead to symptoms similar to those experienced prior to embolization, that is, the following may develop:

A lump or swelling in the scrotum
A feeling of heaviness or discomfort in the testicles, especially after standing for long periods
Pain that worsens throughout the day
Reduced quality of sperm if infertility was an issue before treatment

Seek medical attention if you experience any of the above symptoms. An evaluation may include an ultrasound to check for recurrence of varicocele.

What Can Be Done If Varicocele Returns?

If a varicocele recurs after embolization, various options exist:

A Repeat Embolization: Repeat embolization is very much safe for sealing off any remaining or newly formed veins.
Surgical Repair (Varicocelectomy): In those cases where embolization is not an option, surgery may be recommended for removal of the affected veins.
Observation: If the recurrence is mild and not causing any symptoms or fertility issues, your doctor may recommend monitoring it rather than treating it right away.

How to Reduce the Risk of Recurrence

Never really so much as able to prevent a recurrence, but using an experienced interventional radiologist increases the chances that his procedure would be successful. Good vein health can also be ensured by living a healthy lifestyle, avoiding heavy lifting, and health conditions like hypertension.

Conclusion

It is a rare affair, but recurrence of the varicocele after embolization is possible. The good news is that with appropriate evaluation and timely intervention along with expert care, it can be very well managed. So if you happen to suspect recurrence, visit your physician in order to discuss the options.

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