Concierge interventional radiology · London
Varicocoele embolisation London.
Non-surgical, day-case treatment of a varicocoele through a small vein in the arm or groin. No incision on the scrotum, local anaesthetic with sedation, walk out the same afternoon.
What varicocoele embolisation is
An interventional radiology procedure, not surgery.
A catheter-based treatment that closes the dilated spermatic vein from the inside, with no scrotal or inguinal incision.
Varicocoele embolisation is performed by an interventional radiologist under local anaesthetic with light sedation. A fine catheter is passed through the right common femoral vein in the groin or the basilic vein in the arm, up into the left renal vein, and then selectively into the internal spermatic vein. The catheter never enters the scrotum and there is no incision on the testicle or the groin crease.
Once the abnormal, refluxing vein has been mapped with a small dose of contrast, it is occluded from within. Platinum coils, sodium tetradecyl sulphate (STS) foam sclerosant or a combination of both are deployed along the length of the vein. Blood then drains through normal collateral routes. The dilated pampiniform plexus around the testicle shrinks over the following weeks and the temperature of the scrotum falls back towards normal, which is what allows sperm production to recover.
Indications
When varicocoele embolisation is offered.
The clinical situations where treatment (as opposed to observation) is worthwhile.
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Infertility with abnormal semen
Palpable varicocoele in a man with abnormal semen parameters (count, motility or morphology) and a partner trying to conceive.
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Chronic scrotal ache
Dragging, aching or heavy discomfort in the affected hemiscrotum, typically worse on standing or after exercise.
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Adolescent testicular atrophy
A grade II or III varicocoele in a teenager with a measurable size difference between the two testes on ultrasound.
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Recurrent after ligation
A varicocoele that has come back after previous open or laparoscopic surgical ligation, where re-operation is technically difficult.
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Bilateral disease
Bilateral varicocoeles treatable in a single sitting through one venous access.
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Patient preference
A man who wants to avoid a scrotal or inguinal incision and general anaesthetic.
Diagnosis
Confirming the varicocoele before treatment.
A short work-up that grades the varicocoele and answers whether treatment will change anything.
Assessment starts with a physical examination in a warm room, standing and supine, with and without a Valsalva manoeuvre. A grade I varicocoele is only palpable on Valsalva, grade II is palpable at rest and grade III is visible through the scrotal skin. Only clinical (palpable) varicocoeles are routinely worth treating.
A colour Doppler scrotal ultrasound with Valsalva confirms retrograde venous flow, measures the diameter of the pampiniform plexus and documents any size difference between the two testes. For the infertility indication, at least one semen analysis (ideally two, six weeks apart) is done to confirm abnormal count, motility or morphology before embolisation is scheduled.
How the procedure works
60 to 90 minutes as a day case.
A short, planned procedure in the interventional radiology suite under local anaesthetic and light sedation.
- 01
Access
Local anaesthetic and light sedation. A small nick over the right common femoral vein in the groin, or the basilic vein in the arm. Radial or basilic access is increasingly the default and lets you walk out straight away.
- 02
Catheterisation
A fine catheter is steered under X-ray guidance into the left renal vein and then into the internal spermatic vein. A venogram maps the abnormal, dilated pampiniform plexus.
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Embolisation
The dilated vein is occluded with platinum coils, sodium tetradecyl sulphate (STS) foam sclerosant or a combination. On the right side the vein arises from the vena cava directly.
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Completion
A repeat venogram confirms no residual flow down the treated vein. The catheter is removed and pressure is held over the small entry site. No stitches.
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Discharge
A short recovery on the day-case ward. Walk immediately, home the same afternoon. Total procedure time 60 to 90 minutes.
Efficacy
What the published data show.
Efficacy figures from specialist interventional radiology series and randomised comparisons with surgical ligation.
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Technical success
95% +
Successful catheterisation and occlusion of the target vein in specialist interventional radiology series.
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Semen improvement
60 to 70%
Improvement in count, motility or morphology within 3 to 6 months of treatment for the fertility indication.
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Pregnancy at 12 months
30 to 40%
Natural pregnancy rate for couples where the male partner was treated for a varicocoele-related fertility issue.
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Pain relief
80 to 90%
Resolution or significant improvement of chronic scrotal ache in men treated for a pain indication.
Cost in London
£4,500 to £8,500 all inclusive.
Indicative self-pay pricing across the main London units. Insurer-covered pathways use the same providers.
In short
Varicocoele embolisation in London: £4,500 to £8,500, day case.
The range covers hospital fee, interventional radiologist, anaesthetist for sedation, coils and foam sclerosant, day-case bed, and a follow-up ultrasound and semen analysis at 3 months. Bilateral cases sit at the upper end. We share two or three firm quotes once we know your Doppler findings.
Where it is performed
London interventional radiology units.
A short list of the London centres with the right kit, sedation cover and a same-day discharge pathway.
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HCA London Bridge (Interventional Radiology)
City centre unit with a dedicated interventional radiology suite and same-day discharge pathway.
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HCA The Wellington Hospital
St John’s Wood. Long standing interventional radiology programme covering vascular and urological embolisation.
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Cromwell Hospital (Bupa)
South Kensington. Bupa flagship with radial and femoral embolisation on the day-case list.
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University College London Hospitals Private
Westmoreland Street. Academic interventional radiology partnership.
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King's College Hospital Private
Denmark Hill. Tertiary interventional radiology unit with andrology links.
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The London Clinic
Harley Street. Private day-case interventional radiology with a single-visit pathway.
Recovery
What to expect afterwards.
A quick and predictable recovery, with almost none of the downtime of an operation.
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Walk immediately
You are on your feet within 30 minutes of the procedure. No bed rest is needed with radial or basilic access.
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Home the same day
Day-case pathway. Home a few hours after the coils are placed, with a small dressing over the entry site.
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Office work in 1 to 3 days
Most desk-based patients return to work within 1 to 3 days. No sick note required for most jobs.
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No heavy lifting for 1 week
Avoid gym, running and heavy lifting for the first week to let the entry site settle.
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Sex from day 3 to 5
Sexual activity can resume comfortably from day 3 to 5 in most men.
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Follow-up at 3 months
A repeat scrotal ultrasound and semen analysis at 3 months to document the response.
Compared to surgery
Embolisation vs surgical ligation.
A short, honest comparison of the reasonable options for a symptomatic or fertility-related varicocoele.
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Open microsurgical ligation
Sub-inguinal open ligation of the spermatic veins under an operating microscope. Similar efficacy on semen parameters. Small groin incision, longer recovery, general anaesthetic.
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Laparoscopic ligation
Keyhole ligation of the internal spermatic vein high in the retroperitoneum. General anaesthetic, three small incisions, day-case or one night stay.
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Embolisation
No incision on the scrotum or groin. Local anaesthetic with sedation, radial access possible, walk out the same afternoon. Preferred where surgery has failed.
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Conservative management
Supportive underwear and reassurance for small, asymptomatic varicocoeles with normal semen parameters. No procedure is needed.
Related
Related pathways.
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Testosterone replacement therapy
Private TRT clinic pathway.
Learn more -
Pelvic congestion embolisation
The equivalent procedure in women.
Learn more -
Erectile dysfunction clinic
Assessment and treatment pathway.
Learn more -
IVF
Assisted conception if natural fertility is not enough.
Learn more -
Infertility
Condition guide for couples.
Learn more
Frequently asked
Varicocoele embolisation, honestly answered.
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Is varicocoele embolisation as effective as surgery?
Yes. Published series show comparable improvements in semen parameters and pregnancy rates between embolisation and microsurgical ligation, with a lower complication rate and much faster recovery on the embolisation side.
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Does the procedure hurt?
No. It is done under local anaesthetic with light sedation. You feel a brief scratch at the access site and a warm flush when contrast is injected. The coils and foam are placed inside the vein and are not felt.
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How long before semen parameters improve?
Sperm take around 74 days to mature, so we recheck semen analysis at 3 and 6 months after treatment. Around 60 to 70% of men show a measurable improvement in count, motility or morphology by 6 months.
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Is varicocoele embolisation covered by private medical insurance?
Bupa, AXA, Vitality, Aviva, WPA and Cigna all cover varicocoele embolisation with a specialist referral and a clear clinical indication (fertility, pain or adolescent atrophy). We handle preauthorisation and coding.
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Can both sides be treated at once?
Yes. Bilateral varicocoeles are treated in a single sitting through the same venous access, without extending recovery. The right internal spermatic vein arises directly from the vena cava and is catheterised from the same approach.
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What is the risk of recurrence?
Around 5 to 10% at 12 months in specialist series, which is comparable to microsurgical ligation. A recurrent varicocoele can usually be re-embolised through the same venous approach without the technical difficulty of repeat surgery.
Speak to a London interventional radiologist
Book varicocoele embolisation in London, with the right consultant.
We match you to a UK GMC registered interventional radiologist who performs spermatic vein embolisation regularly, at a London day-case unit with same-day discharge. Insurer preauthorisation handled.