<p><span style="font-family: helvetica;"><img src="/nairobi/PublishingImages/penile%20implant%20body%20image.jpg" alt="" style="margin: 5px;"/></span> </p><p><span style="font-family: helvetica;">For many men, discomfort in the groin is something quietly endured. It's often brushed off as fatigue, heat, or the result of a long day on one's feet. But for some, the real cause lies deeper, a common yet often overlooked condition known as varicocele. Simply put, a varicocele is an abnormality in the veins of the testis. The veins, which normally carry blood from the testicles back to the heart, contain small one-way valves that prevent backward flow. When these valves fail, blood pools in the scrotum instead of flowing out, creating a tangle of swollen veins that resemble varicose veins in the legs.</span></p><p><span style="font-family: helvetica;">This rise in temperature affects the male reproductive system by lowering sperm quality and reducing testosterone levels. Over time, it can even cause a reduction in testicular size and impact fertility. The condition is surprisingly common yet often underdiagnosed because many men don't talk about their symptoms, or they attribute them to something else.</span></p><p><span style="font-family: helvetica;">Varicoceles can develop at any age but are most often detected during adolescence, when physical changes make the veins more noticeable. They are especially common on the left side due to how the body's veins are structured. While mild cases may go unnoticed, some men experience a dull, aching pain in the scrotum, discomfort that worsens after long hours of standing, sitting, or physical exertion. Others may notice swelling or a feeling of heaviness in the testicles. In some cases, the condition becomes visible as enlarged veins that feel like a soft “bag of worms."</span></p><p><span style="font-family: helvetica;">Despite these signs, many men delay seeking help. It's not unusual for patients to come in only when they and their partners are struggling with fertility. They often discover the varicocele through a routine ultrasound or fertility evaluation. An ultrasound scan remains the most accurate diagnostic tool. It allows doctors to visualize the dilated veins and assess whether blood is flowing backward, a key indicator of valve failure.</span></p><p><span style="font-family: helvetica;">For decades, surgery was the standard treatment for varicoceles. The procedure involved making an incision, identifying the faulty vein, and tying it off to stop the backflow of blood. While effective, it required anesthesia, hospital admission, and a few weeks of recovery. Today, however, men have a gentler alternative: varicocele embolization, a minimally invasive procedure that has transformed how the condition is treated.</span></p><p><span style="font-family: helvetica;">We perform the procedure under local anesthesia while the patient is awake. A tiny wire and catheter are inserted through a vein in the neck or arm, just like placing an IV line. Using live X-ray imaging, we guide the catheter to the affected testicular vein, then seal it with small metal coils. These coils block the abnormal vein, preventing further pooling of blood. The body naturally reroutes blood flow through healthy veins, relieving pressure and restoring proper circulation. The entire procedure takes less than an hour and is done on a day-care basis, meaning the patient is discharged the same day. There are no large cuts, no general anesthesia, and recovery is almost immediate.</span></p><p><span style="font-family: helvetica;">Because no incisions are made, patients experience minimal discomfort. Most are able to resume their normal activities within 24 hours. We only recommend avoiding heavy lifting or strenuous activity for about a week to allow the veins to heal properly. Follow-up appointments include ultrasound scans to confirm that the varicocele has resolved and that blood flow has normalized. For patients with fertility concerns, semen analysis may be done after a few months to assess improvements in sperm count, motility, and quality.</span></p><p><span style="font-family: helvetica;">The results are often encouraging. Most patients experience relief from pain and discomfort within days, and we've seen significant improvements in fertility outcomes. The success rates are excellent, and in most cases, the treatment is permanent. Although varicocele embolization is considered very safe, like any medical procedure, it carries some risks, though these are rare. These may include slight bruising or mild pain at the catheter site, and in extremely rare cases, movement of the coils used to block the vein. There's also a minimal risk of clot formation or an allergic reaction to the X-ray dye, but these occurrences are uncommon and well-managed.</span></p><p><span style="font-family: helvetica;">Patients are carefully monitored throughout the procedure and during recovery to ensure safety. The technology we use in the Cath lab gives us real-time images, which allows us to be very precise. Varicocele embolization reflects our growing expertise in interventional radiology, a medical field that uses imaging guidance to diagnose and treat diseases without major surgery.</span></p><p><span style="font-family: helvetica;">In many cultures, men tend to downplay or ignore reproductive health issues. Yet conditions like varicocele are both common and highly treatable. Men shouldn't suffer in silence, if you experience persistent scrotal pain, swelling, or fertility problems, it's important to see a specialist. Early diagnosis and treatment can make all the difference.</span></p><p><span style="font-family: helvetica;">Varicocele embolization is proof that modern medicine can be both gentle and effective. In a single, image-guided session, patients can be treated and discharged on the same day, free from the pain and long recovery times once associated with surgery. For men who've quietly endured discomfort or struggled with unexplained infertility, this minimally invasive procedure offers hope, and a reminder that sometimes, the smallest intervention can bring the biggest relief. Our goal is to make sure men know that help exists. With the right treatment, they can reclaim their health, confidence, and peace of mind.</span></p><p><span style="font-family: helvetica;"><em><strong>By Dr Naushad Karim, Consultant Interventional Radiologist at Aga Khan University Hospital Nairobi</strong></em>
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