Varicocele Embolisation

What is Varicocele Embolisation?

A varicocele is an abnormality of the veins that take blood away from the testicle. Although the veins are seen or are palpable in the scrotum the underlying problem is often higher up in the spermatic vein draining up towards the kidney.Faulty valves or the presence of additional collateral veins can allow reflux or reverse flow which resuls in blood pooling around the testicle with distension and engorgenent of the veins. This is very similar to varicose veins in legs.

Embolisation is a minimally invasive way way of blocking this reverse flow, reducing the distension and strtching of the veins that causes the discomfort.

Varicocele Ultrasound scan
Varicocele Embolisation Coils

The procedure

Traditional treatment of a varicocele was open surgery to tie the veins off in the groin. Interventional radiologists can now offer a minimally invasive day case procedure performed under local anaesthetic and x-ray guidance called embolisation which blocks the reflux in the testicular veins by placing small metal coils in the vein higher up. This stops the reflux and relieves the swelling and discomfort in most cases. Unlike open surgery the patient goes home a few hours later and is back to normal activity virtually immediately.

Referral and Booking

You may have been referred by your urologist, general practitioner or fertility specialist but self-referral is also possible.

The initial ultrasound scan and consultation can be done at any of our locations. The actual embolisation procedures are offered at The Priory Hospital or The Harborne Hospital in Birmingham, or at the Princess Grace Hospital in London.

Initial Investigations

An ultrasound scan of the testicles is arranged to assess the veins and to exclude other more potentially more serious causes of symptoms. The kidneys are usually also scanned as very rarely underlying kidney problems such as a kidney tumour may be the underlying cause of a varicocele by putting pressure on the veins.

Dr. Crowe does the ultrasound scan himself and will discuss the scan results and suitability or ortherwise for embolisation with you at the time.

What is Embolisation

Varicocele embolisation is a minimally invasive day case procedure usually performed under local anaesthetic to treat the varicocele by blocking the refluxing veins.

The day of the procedure

The hospital will provide details of when and where to come on the day. You will be admitted to the ward an hour or two before the procedure.  The embolisation takes place in a dedicted interventional radiology theatre under x-ray guidance and takes 20-30 minutes on average.

Varicocele embolisation can be performed from the neck via the jugular vein or from the groin via the femoral vein. Dr. Crowe’s usual approach is from the groin which most patients find more comfortable.

Afterwards

Following the procedure you will need to lie flat for the first hour and then can sit up for the second hour. Embolisations are normally done in the morning and patients are ready to go home around lunchtime.

Symtoms usually improve significantly within a few days. It is important to remember that the veins are not physically removed so it will still be possible to feel the veins in the scrotum but the swelling, distension and resultant discomfort shuold improve.

Dr. Crowe will see you back for a follow up ultrasound scan after three months.

Next steps

Please contact Dr. Crowe’s secretary on 0121 448 1502. Procedures are performed at The Priory Hospital and the Harborne Hospital in Birmingham and at the Princess Grace Hospital in London.

Most private insurance companies now cover the procedure and for non-insured patients a self-pay package price quote can be obtained from the individual hospital.

Varicocele Embolisation for Male Infertility

Varicocele Embolisation for Male Infertility

Dr. Crowe works with specialist urologists and fertility specialists in investigation and treatment of male infertility. Infertility is frequently a multifactorial problem with contributory factors from both the female and male partners. Similarly there may be multiple contributory factors to male infertility resulting in either a low sperm count or in poor quality sperm with reduced motility or abnormal sperm forms.

It is thought that a varicocele may cause fertility issues as the prominent varicose veins around the testicle lead to heating that may impair sperm production. There have been numerous studies over the years, some of which have yielded contradictory findings, but some of which show benefit in terms of sperm production by treatment of an underlying varicocele. The improvement tends to be more in terms of sperm quality and motility rather than in sperm count and there is a lag phase of about three months before such improvement can be picked up on sperm analysis. This is because sperm production takes approximately 2 to 3 months. Though there are no guarantees are treating a varicocele will necessarily improve fertility it is one correctable potential underlying problem that can be readily treated. It is known that there is a higher incidence of varicocele in men presenting with fertility problems.

If you wish to consider Varicocele Embolisation treatment please read the Varicocele Embolisation Patient Information booklet.

Private Medical Insurance

Dr. Crowe is recognised by all the major private health insurance providers. To avail of your private insurance cover it is essential to contact your insurer in advance and obtain the necessary pre-authorisation for treatment. Dr. Crowe’s office can provide his provider number for the insurance company concerned as well as the procedure codes for the proposed treatment. Having this information before contacting your insurer speeds up the process of getting pre-authorisation.

While Dr. Crowe’s professional fees are within the insurance companies’ published guideline ranges the level of cover will depend on the conditions of your individual policy or that provided by your employer and cover should always be checked in advance. Some policies may stipulate an excess to be paid by the policy holder and this may be invoiced to you directly. There may be annual limits on cover, limits on out-patient cover or restricted cover for pre-existing conditions. Certain policies may also limit the choice of hospitals where treatment can be provided and this is particularly the case when considering treatment in central London. Insurers may stipulate that you must be referred to Dr. Crowe by your general practitioner or specialist but some allow self-referral or provide their own online GP service.

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Self pay

It is not necessary to have private health insurance to avail of private medical care. More and more people are choosing to self-fund private treatment and are finding costs are often less than they had anticipated. Private medical care offers prompt and efficient diagnosis and treatment with your choice of consultant, at a time that suits you, in a clean and pleasant hospital environment.

Upon request price quotes can be obtained for the various treatments offered by Dr. Crowe. Having an initial consultation and scan does not commit you to proceeding with treatment and for more expensive high tech procedures the individual private hospitals can often offer a range of payment options. Although Dr. Crowe’s professional fees are standard regardless of treatment site the total costs are usually lower in Birmingham, reflecting higher hospital and clinic charges in central London.

For diagnostic scans Dr. Crowe can offer ultrasound, CT and MRI scanning at very reasonable self-fund rates that also vary from one private hospital to another. Plain X-Rays required for immigration and pre-employment health screening purposes can also be arranged.

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Overseas patients

Overseas Patients

Dr. Crowe is happy to take overseas referrals and can offer telephone and online consultations. Scans performed in your home country can be reviewed and he can liaise with your local doctors before you travel. Advice can be given on travel and follow up arrangements.

The private hospitals where Dr. Crowe practices can quote all in prices for treatment and assist with booking and arrangements prior to travel.

Dr. Crowe is recognised by many international and expatriate health insurance providers. In other cases the private hospitals may have agreements with international insurers and can facilitate treatment planning by liaising directly with the insurer for price quotes and invoicing.

Dr Crowe is based in London and Birmingham. Birmingham is the second largest city in the UK and is situated approximately 100 miles (160Km) north of London. There are excellent road and rail links and Birmingham International Airport provides direct flights to most European destinations as well as direct links to American, Asian and Middle Eastern cites.

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