What is a varicocele?
A varicocele is an enlargement of the veins in the scrotum. This may cause pain or a heavy sensation in the scrotum. It may also contribute to infertility. A varicocele develops over time.
What is a varicocele embolization?
Embolization is a procedure in which a blood vessel is intentionally blocked to divert blood flow. This procedure is done using image guidance by an interventional radiologist.
Risks of a varicocele embolization for your child
Varicocele embolization is usually a low-risk procedure. The risk may increase depending on your child’s condition, age and health.
The risks of a varicocele embolization may include:
- pain
- infection
- bleeding, groin/neck bruising
- testicular inflammation
- testicular atrophy (shrinkage of the testicles)
- blood vessel or nerve damage
- blood in the urine
Visiting the interventional radiologist before the procedure
Your child will have a clinic visit with the interventional radiologist before the procedure. During the visit you should expect:
- A health assessment to make sure your child is healthy and that it is safe to have sedation or general anaesthesia and to go ahead with the procedure.
- An overview of the procedure, and a review of the consent form with an interventional radiologist.
- Blood work, if needed.
Giving consent before the procedure
Before the procedure, the interventional radiologist will go over how and why the procedure is done, as well as the potential benefits and risks. They will also discuss what will be done to reduce these risks, and will help you weigh any benefits against the risks. It is important that you understand all of these potential risks and benefits of the varicocele embolization and that all of your questions are answered. If you agree to the procedure, you can give consent for treatment by signing the consent form. A parent or legal guardian must sign the consent form for young children. The procedure will not be done unless you give your consent.
How to prepare your child for the procedure
Before any treatment, it is important to talk to your child about what will happen. When talking to your child, use words they can understand. Let your child know that medicines will be given to make them feel comfortable during the procedure.
Children feel less anxious and scared when they know what to expect. Children also feel less worried when they see their parents are calm and supportive.
If your child becomes ill within two days before the procedure
It is important that your child is healthy on the day of the procedure. If your child starts to feel unwell or has a fever within two days before the procedure, let you doctor know. Your child may need to be rebooked.
Food, drink and medicines before the procedure
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Your child’s stomach must be empty before sedation or general anaesthetic.
- If your child has special needs during fasting, talk to your doctor to make a plan.
- Your child can take their regular morning medicine with a sip of water two hours before the procedure.
- Medicines such as acetylsalicylic acid (ASA), naproxen or ibuprofen, warfarin or enoxaparin may increase the risk of bleeding. Do not give these to your child before the procedure unless they have been cleared first by their doctor and the interventional radiologist.
On the day of the varicocele embolization
Arrive at the hospital two hours before the planned time of your child’s procedure. Once you are checked in, your child will be dressed in a hospital gown, weighed and assessed by a nurse. You will also be able to speak to the interventional radiologist who will be doing the varicocele embolization and the anaesthetist who will be giving your child medication to make them comfortable during the procedure.
During the varicocele embolization you will be asked to wait in the surgical waiting area.
Your child will have medicine for pain
Children are given medicine for treatments that may be frightening, uncomfortable or painful. For varicocele embolization, most children are given general anesthesia and local anesthesia to make sure they are comfortable. The type of medicine that your child will have for the procedure will also depend on your child’s condition.
How is a varicocele embolization done?
The interventional radiologist will insert a tiny plastic tube, called a catheter, into a vein in the groin or neck through a small (0.5cm) cut in the skin. The catheter is guided through the veins to the varicocele. The interventional radiologist then inserts material through the catheter that blocks the varicocele and diverts blood to other veins. After the vessel has been successfully blocked, the catheter is removed and pressure is applied to the groin or neck to stop bleeding. No stitches are needed.
The procedure usually takes two hours.
After the Varicocele Embolization
Once the varicocele embolization is complete, your child will be moved to the recovery area. The interventional radiologist will come and talk to you about the details of the procedure. As soon as your child starts to wake up, a nurse will come and get you.
Going home
In most cases, children go home the same day after the varicocele embolization. Your doctor will let you know when they are well enough to go home.
Follow-up
Following the procedure, your child will have a follow-up visit with their urologist. After six months, your child will have an ultrasound and a follow-up clinic visit with the interventional radiologist.
For more details on how to care for your child after varicocele embolization, see Varicocele embolization: Caring for your child at home after the procedure.
At SickKids
At SickKids, the interventional radiologists work in the Department of Diagnostic Imaging – Division of Image Guided Therapy (IGT). You can call the IGT clinic at (416) 813-6054 and speak to the clinic nurse during working hours (8:00 to 15:00) or leave a message with the IGT clinic nurse.
For more information on fasting see Eating and drinking before surgery.
For more information on preparing your child for their procedure see Coming for surgery.