Varicocele treatment

What is varicocele treatment?

A varicocele is a cluster of enlarged veins in the scrotum, rather like varicose veins in the legs. They are common, usually on the left side, and many cause no problems at all. Treatment is only needed for some men.

Varicocele treatment blocks or ties off the affected veins so blood is rerouted through healthy ones. There are two main ways to do this: radiological embolisation, where a thin tube is passed through a vein and tiny coils or a blocking agent seal the faulty veins; and surgery (ligation), where the veins are tied off through a small cut, sometimes using keyhole or microsurgical techniques.

It is usually offered for an aching or dragging discomfort that does not settle, a varicocele that is affecting how a younger testicle grows, or for selected couples having fertility problems where semen quality is affected. It is not a routine treatment for a varicocele that is found by chance and causes no symptoms.

This guide explains what treatment can and cannot do. Importantly, treating a varicocele does not guarantee a pregnancy, and the decision should be made with a urologist (and, for fertility, ideally alongside assessment of both partners).

Types & techniques

There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.

Embolisation vs surgery

Both methods give similar improvements in pain and semen results. The best choice depends on your anatomy, local expertise and your preferences — discuss this with your specialist.

Preparing for your surgery

• Have the reason for treatment confirmed — ongoing pain, a growth problem, or a fertility case with abnormal semen — rather than treating a chance finding.
• For fertility, ideally have a semen analysis and an assessment of both partners before deciding.
• Tell the team about all medicines, especially blood thinners, and any allergy to X-ray contrast dye (for embolisation).
• Arrange a lift home and some time off work (a few days to about two weeks depending on the method).
• Buy supportive underwear, which can ease discomfort afterwards.
• Ask which method is being offered and why, and who will carry it out (urologist or interventional radiologist).

What happens

For embolisation, an interventional radiologist numbs a small area, passes a fine tube into a vein in the groin or neck, and uses X-ray pictures to guide it to the faulty veins. Tiny coils or a blocking agent are placed to seal them. You are awake, it usually takes under an hour, and most people go home the same day.

For surgery, the urologist makes a small cut (usually in the groin) and ties off the affected veins, sometimes using an operating microscope or keyhole instruments. This is often under general or regional anaesthetic as a day case. Whichever method is used, blood then drains through other healthy veins, and the testicle's blood supply is preserved.

Is this operation right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Anaesthetic choices

The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.

The biggest uncertainties are that the varicocele can come back and that, when treatment is for fertility, it may improve semen results without leading to a pregnancy. Ask your specialist what the realistic aim is for you, which method they recommend and why, and what their recurrence rate is.

Published figures to discuss

Recurrence and fertility outcomes vary with the technique used, the man's baseline semen results, and many factors in both partners. Reliable figures come from large series and reviews rather than individual clinics, and 'success' for fertility (a pregnancy) is much less certain than improvement in semen measures alone.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

Recovery — what to expect, and when

Recovery is usually short. Embolisation often allows a return to light activity within a day or two; surgery may need a few days to about two weeks before heavier activity, with supportive underwear and simple pain relief helping in both cases.

• Mild aching, bruising or swelling around the scrotum or groin for a couple of weeks
• A small lump or firmness at a wound or coil site that settles
• Tenderness when active that eases as healing progresses
• No immediate change in semen results — these are checked after a few months

Aftercare

• Wear supportive underwear to ease discomfort in the first weeks.
• Use simple pain relief such as paracetamol as advised.
• Keep any wound clean and dry and follow dressing advice.
• Avoid heavy lifting and strenuous exercise until advised it is safe.
• Look out for and report signs of infection or a significant new swelling.
• Attend any follow-up, including a repeat semen test if treatment was for fertility.
• Know who to contact if you have severe pain, a hot swollen testicle, or fever.

• Supportive underwear bought
• Simple pain relief at home
• Time off work arranged (a few days to ~2 weeks)
• Lift home organised
• Follow-up and any repeat semen test booked
• Clinic out-of-hours contact saved

Scars and how they heal

Embolisation is done through a small puncture in a vein, leaving a tiny mark rather than a scar. Surgery leaves a small scar in the groin (or several tiny scars with keyhole surgery) that usually fades well. Some bruising around the area is normal at first.

⚠ Get urgent help if…

• Severe or sudden testicular pain, or a hot, very swollen, red testicle
• A high temperature, feeling unwell or spreading redness (signs of infection)
• A wound that is bleeding, opening or leaking fluid
• A new, rapidly enlarging swelling of the scrotum
• Calf pain, swelling, chest pain or breathlessness (possible clot — seek urgent help)

Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your surgeon gives you.

Results & realistic expectations

A good result is relief of the aching or dragging discomfort and a settled scrotum, with the veins no longer refilling. Where treatment was for fertility, the aim is an improvement in semen quality over the following months.

It is important to be realistic: treating a varicocele does not guarantee improved sperm results or a pregnancy, and outcomes vary between men. Your specialist should explain what success means in your case and arrange the right follow-up tests.

For many men the benefit is long-lasting, but a varicocele can return if treated veins reopen or new ones enlarge, sometimes needing a further procedure. Microsurgical techniques are designed to reduce this risk. Any improvement in semen quality is reassessed over a few months rather than judged immediately.

Combining with other procedures

When treatment is for fertility, it is best considered as part of a wider couple's assessment, which may include semen analysis, hormone tests and review of the female partner. Some couples may also be considering assisted conception (such as IVF or ICSI), and the role of varicocele treatment should be discussed in that context.

Follow-up & long-term care

You are usually reviewed to check the wound or puncture site has healed and that symptoms have settled. If treatment was for fertility, a repeat semen analysis is arranged after about three to four months, with onward referral to a fertility service if needed.

Revision and secondary surgery reality

• A varicocele can recur if treated veins reopen or new collateral veins enlarge, sometimes needing a repeat procedure.
• A man treated by one method may occasionally need the other (for example, surgery after a failed embolisation).
• A hydrocele forming after surgery can itself need treatment.
• Where fertility is the goal, further fertility treatment may still be needed regardless of varicocele repair.

Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.

What good aftercare looks like

• Clear advice on pain relief, supportive underwear, wound care and activity
• A named contact for problems such as severe pain, swelling or signs of infection
• A planned repeat semen analysis after a few months when treatment is for fertility
• Onward referral to a fertility service when appropriate
• Honest discussion of what to do if the varicocele recurs

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Whether embolisation or surgery is used, and which surgical technique (open, microsurgical or laparoscopic)
• Operator's fee (urologist or interventional radiologist) and the facility or theatre fee
• Anaesthetic or sedation, where used
• Imaging and any coils or blocking devices for embolisation
• Pre-treatment tests such as semen analysis and scans
• Follow-up appointments and a repeat semen test if treatment is for fertility

• The operator and facility fees and what is included
• Whether anaesthetic or sedation costs are included
• Imaging, coils or devices used in embolisation
• Pre-treatment semen analysis and scans
• Follow-up visits and repeat semen testing
• What happens, and what it costs, if the varicocele recurs or a complication occurs

On the NHS? Varicocele treatment is available on the NHS when there is a clear clinical reason such as ongoing pain, impaired testicular growth or selected fertility cases; criteria vary by area, and symptomless varicoceles found by chance are often not treated.

You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a surgeon safely

• Check your surgeon is on the GMC Specialist Register for this area.
• Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
• You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
• Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good surgeon will welcome every one of these.

• Why are you recommending treatment for my varicocele, and what is the aim?
• Would you suggest embolisation or surgery for me, and why?
• What is your recurrence rate, and what happens if the varicocele comes back?
• If this is for fertility, how likely is it to improve my semen results, and what about a pregnancy?
• What are the chances of a hydrocele or other complication with the method you suggest?
• When will my semen be retested, and what would the next step be?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the surgeon who carries out my operation, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this operation not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified surgeon for varicocele treatment

Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.

How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: BAUS — Varicocele embolisation (patient leaflet) NHS (Guy's and St Thomas') — Varicocele embolisation NHS (Hull) — Varicocele embolisation patient leaflet Cochrane review — Surgery or embolisation for varicoceles in subfertile men (PMC) Percutaneous embolisation for varicocele — PMC review

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.