Should I have Varicocele Embolisation?

"I was pleased to review the patient. He is still troubled with intermittent pain and discomfort felt in the left hemiscrotum. He cannot detect any other abnormality. The ultrasound performed concurs with that performed in the other medical facility, showing a mild degree of microcalcification on both testes but with no focal lesion and almost certainly of little import. There is a little excess fluid on each side, around the testes, of no worry, and there is confirmed to be a refluxing left scrotal varicocele. Given his background, I think a period of observation would be best before contemplating therapeutic embolisation to the left testicular vein, about which he has with a radiologist in detail. This certainly would be the best option of treatment if that were to be carried out and is performed as a day case under local anaesthetic and is generally successful. However there is a roughly 5% incidence of recurrence of a varicocele, problems with migration of coils, which is something of which I have never seen, and also rarely development of the hydrocele increasing. I do think a period of observation would be prudent, given his overall situation, and I would suggest repeat ultrasound in, perhaps, 6 months time and review at that stage."

I love how he says "generally successful". "Generally successful" has no real meaning actually. It just means that the ebolization was done, and you didn't get severely damaged as a result. It has nothing to do with decrease of pain, it has nothing to do with improvement of fertility, it has nothing to even do with varicocele re-development or varicocele reduction! It's such a coy way of phrasing it. What is "successful"? It sounds like such a manipulative email to me. So friendly, but at the same time really isn't giving any consideration to you at all. 

The facts are that embolization helps 1 in 17 men attain a successful pregnancy--if that. It's Not considered as an effective procedure for pain relief. Actually the redevelopment rate ranges from 5-20% for left-sided varicocele, and varies greatly from radiologist to radiologist (up to 10%). Coil migration is noted firmly at 1% in literature. Just because he hasn't personally seen it, doesn't change the fact that there is a 1% chance for you to lose your testicle. And for what benefit? That's the real question. What are the real benefits? And what are the real risks? 

Very manipulative letter if you ask me. AND he doesn't even know what's causing your pain. Is it the hydrocele? Is it the calcification? Or is it the varicocele? The fact is he doesn't know. And now, taking a wild shot in the dark and picking to "treat" varicocele is kinda an iffy decision if you ask me. The other conditions will remain or even worsen because of the procedure. He calls it a "minor" hydrocele development/worsening rate. But, that "minor" rate is 10-20%. Minor? 

I don't know man. I don't recommend these junk procedures. The risks are very real, and the results are questionable. You'll notice something is very off and wrong if you sit down and ask them for the hard-facts. E.g. What is the NNT of embolization (it's 17, so, only 6% of men attain a benefit from the procedure). Does embolization really cure pain? Nope. Barely any scientific literature on embolization and pain. And they're all poorly designed. So, if science doesn't really back it, why does he recommend it? That's a good question. As well, what are the chances of your pain originating from the other conditions? What are the exact and general rates of negative side effects? You can refer to this chart I made by compiling everything I've found about Embolization: https://www.varicocelehealing.com/surgery-risks.html

You can even show that chart to him. Nothing to argue about from there. The facts are the facts.

On a final note: I hate it when doctors advise to "observe" something that is persistent and consistent. He obviously has no clue that there is a lot that can be done to compeletely cure varicocele pain: www.varicocelehealing.com/varicocele-pain-treatment. 

Lesson: It might seem like he has your best interest in mind, and he really might, but that doesn't mean he is advising what's actually best for you. Know your options. Visit www.varicocelehealing.com to learn what you can do.