Wednesday, January 5, 2011

Embolization for Varicocele – Male infertility


Embolization for Varicocele – Male infertility

Infertility affects lakhs of couples in India. varicocele of scrotum are the most common causes of infertility and is seen in 30-40% of these couples.

The common causes of varicocele by non-function of valves in testicular vein which leads to aching pain, testicular atrophy (shrinkage) and fertility problem due to decreased sperm count; decreased motility of sperm, and an increase in the number of deformed sperms.

Due to lack of awareness about non-surgical treatment, patients frequently undergo surgical treatment, which results in surgical scar, long hospitalization, chances of
infections, and done under general anesthesia.
Non-surgical treatment (varicocele embolization) is performed by an interventional radiologist and benefits are:


  Nearly no pain,
  No surgical scar,
  Performed on day care / one day hospitalization,
  Patients are able to return to normal daily activities immediately.
  A patient with both side varicoceles can have them fixed simultaneously in one sitting,
  No general anesthesia / sutures / infections & it is cost-effective.


Diagnosis of varicocele is fairly simple through physical or color flow ultrasound Doppler examination. The varicocele is typical on the left side, scrotum look like a “bag of worms”.Non-surgical catheter directed embolization is an outpatient treatment. Specifically trained interventional radiologist makes a tiny nick in the skin at the groin or neck using local anesthesia and a thin catheter is passed and directed to the testicular vein. With contrast dye injection, interventional radiologist map out exactly where the problem is and by using coils or particles, by embolization, blood flow is re-directed to other healthy pathways. Whole non-surgical treatment procedure is pain less and takes about one hour.


Picture shows normal anatomy and varicocele      

Varicocele Embolization is effective in improving male infertility and costs about the same as surgical ligation. The study shows, sperm concentration improved in 83 percent of patients undergoing embolization compared to 63 percent of those surgically ligated.

Varicocele Embolization technique



FREQUENTLY ASKED
QUESTIONS
VASCULAR INTERVENTION EMBOLIZATION
SURGICAL
Does the procedure hurt?
No, Local anesthesia only
Need, General anesthesia
How long do I stay in hospital?
No overnight stay required
Require an overnight stay
When can I return to normal work?
Within 24 hrs
2-3 Weeks
Is there pain after the procedure?
Very little.
Yes but managed with Tab / injection analgesia
Will it cause sexual dysfunction?
No
No
Is there any scarring?
No
Yes - depending on surgical technique.
For more in-depth information contact :

Dr. Pradeep Muley M.D.
Head & Senior Consultant Interventional Radiologist
Fellow, Neurointerventional Radiology, John’s Hopkins Medical Institutions, USA
Visiting Associate, Neurointerventional Radiology, Iowa University, USA
Fellow Interventional Radiology, Singapore General Hospital, Singapore
Lecturer Vascular & Interventional Radiology, KEM Hospital, Mumbai.
Neuroradiology, AIIMS, New Delhi.

Mobile 098104 92778 or E-mail at muleypradeep@hotmail.com
Website http://www.indianinterventionalradiology.in