Varicocele embolization is a non-surgical, outpatient procedure performed only by a trained interventional radiologist (IR) that specializes in embolization techniques. Using image guidance, a thin catheter like an IV is inserted (usually via a vein in the groin or neck) and guided to the veins feeding the varicocele. These veins are then blocked off using tiny coils, foam sclerotherapy, or a combination of both. The goal is to redirect blood flow away from the abnormal veins, relieving pressure and improving symptoms or fertility outcomes.
Unlike surgery, embolization does not involve incisions or general anesthesia, and patients go home the same day.
Varicocele Embolization: What are Coils and are they Safe
One of the most common concerns patients have is about the use of metal coils. These small, sterile implants are typically made of platinum or stainless steel, and they act like roadblocks—permanently closing off the abnormal veins. In today’s medicine, almost every type of surgery involves implanting some type of metal, silicone, plastic or other material. For example, surgical metal clips for gallbladder removal, metal tags for hernia repair, metal prosthetic stems for joint replacement, metal clips for bleeding ulcers and hernias and so on.
Key facts about coil safety:
- Biocompatible: Coils are designed to stay in the body without causing harm or triggering immune reactions.
- Non-magnetic: Most coils are MRI-safe and won’t set off metal detectors.
- Proven use: Coils have been used safely in medicine for decades, including for brain and body aneurysms, vascular disorders, bleeding pelvic fractures/trauma and others.
There is no credible evidence that varicocele coils “migrate” or cause long-term systemic harm. One key difference between surgical metals placed for common surgeries and metal coils is that the body quickly walls off the coil inside the vein, forming a stable, scarred segment that’s no longer active or exposed to circulation.
Varicocele Coil-Only Embolization vs. Coil Plus Sclerotherapy Embolization
Interventional radiologists may use coils alone, foam sclerotherapy alone, or a combination of both. The choice depends on the physician’s technique, experience, and patient anatomy.
Varicocele Coils Only Embolization
Using only coils is a straightforward, effective approach that works by mechanically blocking the vein. However, multiple coils are required, especially if the vein has several branches. In some cases, small side channels can be missed, leading to recurrence.
- Pros: No chemical agents used ; highly durable
- Cons: May require more coils ; higher chance of incomplete closure in complex anatomy.
Varicocele Embolization with Coils and Sclerotherapy (e.g., STS Foam)
Sclerotherapy involves injecting a chemical agent (commonly sodium tetradecyl sulfate, or STS) into the vein, which causes the inner lining to collapse and scar down. This is how varicose veins and spider veins in the legs are treated. This medication is injected causing those unsightly veins to close. For varicocele embolization, when sclerotherapy is combined with coils, the foam flows into small branches the coils can’t reach resulting in a better result.
- Pros: More complete closure; fewer coils needed; lower recurrence rates
- Cons: Mild chemical irritation or inflammation possible; risk of temporary side effects like flank pain or nausea
Our Practice’s Approach
In our practice, Dr Allaei’s preference is to minimize the number of coils placed by combining the treatment with STS foam sclerotherapy. This dual approach allows our doctor to:
- Achieve more complete vein closure
- Limit the amount of permanent implant material
- Reduce procedure time and improve outcomes
The result? Fewer materials used, faster recovery, and lower recurrence.
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Varicocele Embolization: Success Rate
Clinical studies have shown that varicocele embolization is highly effective:
- Pain relief: 80–95% of men report reduced or eliminated scrotal discomfort.
- Fertility improvement: Sperm count and motility often improve within 3–6 months. Pregnancy rates after embolization are comparable to surgical outcomes.
- Recurrence rate: 5–10%, which is on par—or better—than surgical options, especially when sclerotherapy is used alongside coils.
Varicocele Embolization: Recovery and Downtime
Embolization is an outpatient procedure that typically takes under an hour. Afterward:
- Most patients return to work the next day.
- You can resume light activities within 24 hours.
- Heavy lifting or intense exercise is usually avoided for 5–7 days.
Compared to surgery, which often requires incisions, stitches, and up to 2 weeks off work, embolization offers a much smoother recovery.
Varicocele Embolization: Risks and Side Effects
Like all medical procedures, embolization carries some risks—but they are typically minor and temporary. These include:
| Potential Risk | How Common | Details |
|---|---|---|
|
Mild groin or scrotal discomfort |
Common (20–30%) |
Lasts a few days; managed with OTC pain relievers |
|
Nausea or flank pain |
Uncommon (~5%) |
Usually related to foam irritation; short-lived and treated at time of procedure |
|
Coil sensitivity or awareness |
Rare |
Most patients are not aware of coils once placed |
|
Recurrence of varicocele |
5–10% |
Lower with experienced radiologists and sclerotherapy use |
|
Non-target embolization |
Extremely rare (<1%) |
Avoided with careful imaging and technique
|
|
Allergic reaction to contrast dye |
Rare |
Pre-medication given if allergic history present |
Compared to varicocele surgery, embolization avoids many of the risks like:
- Hydrocele formation (fluid buildup around testicle).
- Artery or nerve injury.
- Incision site infection or scarring.
- Longer recovery and anesthesia-related risks.
Embolization Coil Safety in the Long Term
You might be wondering, “Will I always have metal coils in my body?”
The answer is yes—but they are permanently sealed off in a non-active vein, and most patients forget they’re even there. There is no evidence that coils cause long-term systemic issues, hormone changes, or infertility.
Also, many patients ask about MRI safety. Most modern coils are labeled MRI-compatible or MRI-conditional, meaning they’re safe under specific scanning conditions. Let your doctor and radiologist know before imaging, just in case.
Varicocele Embolization vs. Surgery: Which One is Best?
Here’s how the two compare side by side:
| Feature | Embolization | Surgical Varicocelectomy |
|---|---|---|
|
Invasiveness |
Minimally invasive (no incision) |
Surgical incisions required |
|
Anesthesia |
Local + sedation |
General or spinal anesthesia |
|
Recovery time |
1–2 days |
7–14 days |
|
Return to work |
Next day |
1–2 weeks |
|
Risk of hydrocele |
Rare (<1%) |
5–15% |
|
Arterial injury risk |
Extremely rare |
Higher (especially in open procedures) |
|
Fertility improvement |
Comparable to surgery |
Proven effective, widely used |
|
Recurrence rate |
5–10% (lower with coils + foam) |
10–15% (higher in teens and bilateral) |
|
Scarring |
None |
Visible (1–2 inch incision) |
|
Long-term foreign material |
Coils may remain in sealed vein |
None |
Why Should I Choose Embolization?
Embolization may be the best option if you:
- Prefer a non-surgical, outpatient procedure
- Want faster recovery with less discomfort
- Have a recurrence after surgery
- Are an athlete or have physically demanding work
- Have concerns about scarring or hydroceles
- Want a fertility-preserving approach
Varicocele Embolization: Who is a Good Candidate
To be able to do varicocele embolization, the gonadal vein must be large enough for the doctor to access with a catheter. This can only be determined by prior imaging like a CT scan of the abdomen or intraoperatively during the procedure. If the vein is too small and cannot be found, the embolization approach is not possible. Patients in this situation must be treated surgically. Our doctor will do the appropriate work up to make sure embolization is possible before you are scheduled for any treatment. If embolization is not possible, our doctor can refer you to a urologist to discuss the microsurgical varicocelectomy option.
Varicocele Embolization: A Safe and Proven Alternative
Varicocele embolization is a safe, effective, and minimally invasive option for men dealing with discomfort, swelling, or fertility issues. While coil placement may sound intimidating, these implants have an excellent safety profile and have been used in medicine for decades. When combined with STS foam sclerotherapy at our practice, embolization can often achieve better vein closure using fewer coils and with lower recurrence.
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We are Here to Help
Request an Appointment to meet with our varicocele specialist who will review your imaging, labs and history to determine if you are candidate for the procedure, and the outcomes you can expect. Each person is an individual and should discuss the potential risks and benefits of embolization and other treatments with our doctor to decide which option is best.
Appointments are available via an online video telehealth platform or in person at one of the offices in Los Angeles, Orange County or San Diego. Why should you choose us? Read here
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- May M, et al. Recurrence after varicocele embolization: incidence and clinical impact. World J Urol. 2006;24(6):611–615. https://doi.org/10.1007/s00345-006-0116-7
- Al-Kandari AM, et al. Comparison of surgical ligation and embolization of varicocele. J Endourol. 2007;21(6):590–594. https://doi.org/10.1089/end.2006.0333
The above information explains what is involved and the possible risks. It is not meant to be a substitute for informed discussion between you and your doctor, but can act as a starting point for such a discussion.
