Varicocele Surgery or Embolization Which is Better?

Men experiencing a lump or swelling and enlarged veins in the scrotum could be suffering from varicocele. There are many advanced and comprehensive care and treatment methods available nowadays for varicocele. Medically, the most common treatment for varicocele is varicocele surgery or embolization. Both the options aim to treat varicocele and potentially improve fertility, but understanding their individual pros and cons is crucial for making an informed decision among which method is better for the patient.

Varicocele Treatment Methods: Surgery and Embolization

Varicocele Surgery:

• Administration of anesthesia:  Before the varicocele surgical procedure, the patient is prepared by taking a medical history report, conducting certain physical examinations, and performing suggested diagnostic tests such as ultrasound to confirm the presence and severity of the varicocele. During the varicocele surgical process, the patient is administered either local anesthesia with sedation or general anesthesia to ensure they are comfortable and pain-free during the procedure.

• Accessing the Varicocele: Depending on the surgical technique used, varicocele surgery begins with an incision in the scrotum, groin, or lower abdomen. The varicocele-causing dilated veins in the scrotum are made accessible to the surgeon. The cut is normally made in the lower abdomen, permitting direct admittance to the impacted veins, or little entry points are made, and a camera and specific instruments are utilized to get to the varicocele.

• Ligation or Impeding of Veins: The following stage is to ligate (tie off) or block the impacted veins to redirect the bloodstream from the varicocele. For this reason, the doctor could settle on different choices like tying or eliminating the veins, or the specialist could utilize clasps, stitches, or different materials to ligate or obstruct the veins. In the wake of treating the varicocele, the entry points are painstakingly shut with stitches or staples.

Varicocele Embolization:

• Local anesthesia: The doctor will administer a local anesthetic to numb the area where the catheter will be inserted. In some cases, conscious sedation may be used instead.
• Catheter insertion: Using ultrasound guidance, the doctor will make a small incision, usually in the groin area, and insert a catheter (a thin, flexible tube) into a vein. The catheter is then directed through the vein until it reaches the affected varicocele.
• Embolization: Once the catheter is in place, the doctor will use contrast dye and fluoroscopic X-ray guidance to visualize the varicocele and its surrounding blood vessels. They will then introduce embolic material (such as coils or special liquids) through the catheter and into the varicocele to block the abnormal veins. The embolic material causes the varicocele veins to clot and close off, preventing blood from flowing into them.
• Completion and recovery: After the embolization is complete, the catheter is removed, and pressure will be applied to the insertion site to prevent bleeding. You may be asked to lie flat for a short period to allow the incision to seal. A bandage or compression dressing will be applied to the incision site. You will then be taken to a recovery area, where you will be monitored for a few hours before being discharged.

Benefits of Varicocele Surgery and Embolization

Both varicocele surgery and embolization procedures aim to block or reroute blood flow away from the enlarged veins, alleviating pressure and restoring normal circulation. Here are the primary advantages of varicocele surgery and embolization:

• Elimination of symptoms: Varicocele medical procedures of surgery and embolization aid in reducing symptoms like scrotal torment, distress, or a weighty inclination in the scrotum. For those who are experiencing these symptoms, this has the potential to significantly enhance their quality of life. The testicle size after varicocele surgery is also reduced, and the patient experiences less discomfort.
• Improved fertility: Varicoceles can obstruct sperm creation and quality because of the raised testicular temperature and modified bloodstream. Careful treatment with surgery or embolization of the varicocele can further enhance fertility in men by re-establishing typical bloodstream and temperature guidelines in the testicles.
• Anticipation of further enlargement: Varicoceles is an ever-evolving condition that deteriorates over time if it is not treated well on time. Careful treatment can keep the varicocele from turning out to be more articulated and causing expanded distress or intricacies.
• Limited Chance of Testicular Decay: At times, untreated varicoceles can prompt testicular decay (shrinkage). Careful treatment can assist with forestalling this complexity.
• Possibility of Reducing Pain: For people encountering huge scrotal agony connected with their varicocele, medical procedures such as surgery and varicocele embolization can mitigate this aggravation and work on the general well-being of the scrotal veins.
• Upgraded Cosmesis: On the off chance that the varicocele is apparent, which is at the grade III degree of varicocele, careful treatment can work on the restorative appearance of the scrotum as the testicle size after varicocele surgery is reduced.
• Expanded Certainty: Varicoceles can cause mental misery in certain people. The varicocele treatment, whether surgery or embolization, are the best technique to treat varicocele, as it can support certainty and ease concerns connected with the condition.

Potential complications or risks associated with varicocele surgery and embolization

While varicocele surgery and embolization procedures are generally safe procedures, there are potential complications and risks associated with them. It is important to discuss these risks with your doctor before undergoing any procedure. Here are some potential varicocele embolization and varicocele surgery side effects observed by the patients:

Varicocele Surgery:

• Infection: There is a risk of infection at the surgical site, although it is relatively low.
• Bleeding: Excessive bleeding during or after surgery is possible, although it is rare.
• Hydrocele: In some cases, fluid accumulation (hydrocele) may occur around the testicle after surgery, leading to swelling and discomfort.
• Recurrence: A varicocele may recur in some cases, especially if the surgeon does not completely close off the affected veins.
• Damage to surrounding structures: There is a slight risk of injury to nearby structures such as arteries, nerves, or the vas deferens (the tube that carries sperm from the testicle).

Varicocele Embolization:

• Allergic reactions: Some individuals may have an allergic reaction to the contrast dye used during the procedure.
• Recurrence: In a small percentage of cases, the varicocele may recur after embolization, requiring further treatment.
• Damage to blood vessels: There is a slight risk of injury to the blood vessels during the catheter insertion or embolization treatment process.
• Testicular artery injury: In rare cases, the testicular artery may accidentally be obstructed during the procedure, potentially affecting blood flow to the testicle.

It is essential to remember that these complications are relatively uncommon, and most individuals undergo varicocele surgery or embolization procedures without experiencing any significant issues. Your doctor will evaluate your specific situation and discuss the potential risks and benefits of the procedure with you.

Varicocele Surgery and Embolization Treatment Cost in India

The cost of varicocele surgical treatment is not the same across various regions in the country. Several factors influence the expenditure of this treatment, and the final cost can vary for each individual. Generally, the estimated varicocele surgery cost ranges from Rs.40,000 to Rs. 70,000. However, the varicocele embolization treatment cost in India varies in the range of about Rs. 1,25,000 to Rs. 1,60,000.

Some common factors that affect varicocele surgery and the varicocele embolization cost in India include:

• The general consultation fees of urologists generally vary a lot according to the experience and the practice location of the doctor. The consultation charges can vary based on the doctor’s experience, the city in which they practice, etc.
• The patient needs a variety of post-operative services to guarantee full recovery following surgery. To guarantee a thorough and smooth recovery, patients must get physiotherapy as well as medication for pain control and infection prevention.
• The cost of surgery can significantly vary due to the choice of the hospital done by the patient. Hospitalization fees differ from hospital to hospital. In comparison to government hospitals, the cost of the full treatment procedure is higher in private hospitals or clinics.
• The cost of surgery can be greatly influenced by the city of the treatment.

Recovery Procedure associated with varicocele surgery and embolization

The varicocele surgery recovery time and the embolization recovery period can vary from person to person, but here are some general guidelines that are followed by the patients:

• Varicocele surgery and embolization procedures are often performed as an outpatient procedure, which means you can generally go home on the same day of the treatment. However, in some rare cases, an overnight hospital stay may be required.
• The patient may experience some pain or discomfort in the scrotal area following surgery. Your doctor will prescribe pain medication to help manage any post-operative pain. It is important to follow the prescribed dosage and instructions for pain medication.
• It is recommended to take it easy and rest for the first few days after surgery, which improves the varicocele surgery recovery time. Avoid strenuous physical activities, heavy lifting, and exercise during this initial recovery period. You may need to take a few days off from work or school to allow your body to heal.
• Wearing scrotal support or snug underwear can provide support and help reduce swelling and discomfort. Your doctor may recommend wearing a scrotal support garment for a period of time following surgery.
• Applying ice packs to the surgical area can help reduce swelling and provide relief. Your doctor may recommend using ice packs for short periods of time during the first 24 to 48 hours after surgery or embolization.
• The patient will have scheduled follow-up appointments with the concerned doctor to monitor recovery progress. They will assess the surgical site, check for any complications, and provide further instructions for your recovery.
• The timeline for resuming normal activities can vary depending on the health condition of the patient, the surgical procedure, and the recovery process. In general, you should avoid strenuous activities, heavy lifting, and exercise for a few weeks following surgery. Your doctor will provide specific guidance on when you can gradually resume normal activities.

• The patients are suggested to avoid sexual activity and ejaculation for a period of time after varicocele surgery. Your doctor will provide guidance on when it is safe to resume sexual activity based on your individual case.

It is important to closely follow the post-operative instructions provided by your doctor and report any unusual symptoms or concerns during your recovery period. If you have any questions or experience complications, it is best to consult with the doctor for personalized advice and guidance.

Conclusion

The varicocele treatment, whether surgery or embolization, is a journey, not a destination. Regardless of the chosen approach for the treatment, maintaining a healthy lifestyle with a balanced diet, regular exercise, and stress management plays a vital role in optimizing sperm health and overall well-being.

Here are some additional factors to consider for the good health and smoother recovery of the scrotal veins:

• Having a supportive partner and network can be invaluable during recovery and beyond.
• Dealing with infertility can be emotionally challenging. Seek support groups or therapy if needed.
• If natural conception remains unsuccessful, alternative methods like ICSI or IVF may be explored.

Remember, you are not alone in this journey. With the right information, informed decisions, and a supportive network, you can navigate the varicocele battlefield and emerge victorious on the path to fatherhood.