Varicocele and uterine fibroids
Varicocele and pelvic vein embolization
The dilated veins responsible for varicocele and chronic pelvic pain are closed with cyanoacrylate, an embolic agent that has proven superior to other methods.
How it is performed
When the valves of the gonadal veins fail to function properly, blood pools and dilates the venous plexuses: in men this presents as varicocele, in women as pelvic congestion with a dull ache that worsens when standing and towards the end of the day. Through a small venous puncture (arm, neck or groin), a catheter reaches the responsible vein, which is closed with cyanoacrylate (an embolic glue) — an embolic agent that has proven superior to other methods such as microcoils and sclerosing agents. Blood flow is redirected through healthy circulation.
Who it is for
- Symptomatic varicocele or varicocele associated with abnormal semen parameters
- Chronic pelvic pain from pelvic venous congestion
- Atypical varicose veins of the buttock, thigh or vulva fed by the pelvic circulation
Recovery
Day-case procedure, with no surgical incisions: you can walk after a few hours and return to work in 1-2 days. Pain improvement is generally progressive over the following weeks.
Conditions treated in this area: chronic pelvic pain and pelvic varicocele, uterine fibroids with pain and bleeding.
Scientific evidence
Systematic reviews on embolization for pelvic congestion syndrome report pain improvement in the large majority of patients, with a low complication rate. For varicocele, interventional radiology case series document high technical and clinical success rates, with a minimally invasive approach under local anaesthesia. Prof. Ezio Lanza is first author of a study on the long-term effectiveness of male varicocele embolization with NBCA-MS glue and on catheter choice (International Urology and Nephrology, 2024), which documents stable results over time with a low recurrence rate.
References on PubMed
- Long-term efficacy and catheter choice in male varicocele embolization using NBCA-MS glue
Lanza E, Mininni A, Tomasino L, et al. — Int Urol Nephrol, 2024 · PMID 39739219
- Pelvic Congestion Syndrome: Systematic Review of Treatment Success
Brown CL, Rizer M, et al. — Semin Intervent Radiol, 2018 · PMID 29628614
- Efficacy of embolotherapy for the treatment of pelvic congestion syndrome: A systematic review
Hanna J, Bruinsma J, et al. — Ir J Med Sci, 2024 · PMID 38294607
- Varicocele Embolization: Interventional Radiologist's Perspective
Torkian P, Rosenberg M, et al. — Semin Intervent Radiol, 2022 · PMID 36561796
Published data describe average results in groups of patients and are not a prediction of an individual outcome. The indication for treatment must always be assessed during a consultation.
Risks, costs and opinions
The three questions patients ask most often before deciding, with clear answers.
What are the risks of varicocele and pelvic vein embolization?
It is a minimally invasive endovascular procedure performed as a day-case, under local anaesthesia. The most common issues are transient: a small bruise or soreness at the access point, and in some cases a post-embolization syndrome with pain, a feeling of being unwell or a low-grade fever in the following days, manageable with medication. Relevant complications (contrast reaction, unintended embolization of nearby vessels, problems at the puncture site) are rare and are discussed one by one during the consultation, with the informed consent in hand.
How much does the varicocele and pelvic vein embolization cost?
The cost depends on the setting in which the procedure is performed: some treatments are available through the National Health Service or under agreement, others privately or through insurance. The quote is given clearly before scheduling the treatment, and includes the assessment, the procedure and the planned follow-up. During the consultation I tell you which pathway is available in your case: you do not have to decide before knowing the cost.
Does it really work? What patients and the literature say
The most frequent questions are "does it really work?" and "how long does the result last?". The honest answers come from the scientific literature cited on this page, not from online stories: they describe average results in groups of patients and do not guarantee an individual outcome. Reviews and experiences found in forums concern cases different from yours, often with different indications and techniques. During the consultation we review your imaging and I tell you frankly whether you are a good candidate, what alternatives exist and when another pathway is preferable.
Want to know if it is right for you?
At the first consultation we review your clinical history and previous imaging together.