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Possible to do Varicocele Embolization Twice???

Hi

I had varicocele embolization done about 5 years ago - to treat a varicocele on the left side. It worked, but reappeared again recently this year. I'm wondering if its possible to have this same procedure done again.

I do not want surgery or laproscopic surgery done - as it is too invasive - requires anesthesia - longer recovery period... etc..

Does anyone know?

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Avatar universal
It happened pretty much two days afterward. Effectively my whole body just went haywire. It felt like a system wide rejection of either the materials, the procedure or both. Was pretty terrifying to be honest. I agree about the removal. In two minds but have given it the best part of a year and not much improvement still so it feels like a logical step to remove and hope for the best. The varicocele also recurred but not as bad as previously so I guess that’s something. Pain isn’t as bad down there but to be honest that pain didnt bother me too much. It’s almost weird sitting down or crossing your legs and not having to worry about your nads hurting. Kind of have a built in reflex for that now.

Have you heard of guys having them removed?

Glad you haven’t had any issues. Did it relieve your varicocele? Do you mind me asking why you had it done? Mine was for fertility.
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The time frame certainly fits so it seems logical it could be the coils. It’s a difficult decision though. Yeah no problem. I had mine due to pain and fertility problems. My count rose significantly and the pain subsided. I don’t know of anyone that has had them removed but I don’t doubt it’s fairly straightforward. The problem is they can always cause more damage doing it. Find a decent urologist if you decide that’s what you want to do. Are you in pain everyday?
Too right and agree. Happy it worked so well for you. I havent had my count checked yet with everything else that's been going on but i do notice less pain down there too. Though to be honest I'd much prefer the varicocele pain than all of the other stuff going on.

Yeah the pain is pretty well constant. Have had 3 or 4 painless days since getting it down and those were just magic.

I've found a couple of urologists that are open to taking them out at my election. Not sure how to pick a good one. They're both kidney transplant surgeons and both would do it laparoscopically. The only thing is they both think they'll need to also take the artery to remove the coils. I've read up on palomo and seems there isn't too large an impact as there are two collateral arteries to supply the testicle. But yeah a tough decision.
Yeah I think in palomo  varicocelectomy they used to take the artery without any complications so I wouldn’t let that put you off. I suppose you aren’t supposed to have these issues after an embolization either so I guess you can never be too careful. I think give it another few months and if there’s no improvement and it’s effecting your life that much you should probably just go for it. Are you still able to work and function day to day?
Avatar universal
You’ve just proved my point. That coil was dislodged during the procedure itself. Might I also add it was a tornado coil being used to treat an avf. This typically involves embolizing high flowing vessels nothing like the gonadal vein. As for the person you spoke to I would imagine it probably dislodged early on but he was asymtomatic at first. Coil migration doesn’t normally cause symptoms. Once the vein has fibrossed it’s going nowhere. You can even have mri’s just like you can with surgical clips. Coil migration is a known risk but it always happens very early or certainly within the first 48 hours. That’s why they tell you to rest up. Might I add it’s incredibly rare.  Yeah mine literally gave me my life back. I had two grade 3 varicocele s and my life was being ruined by the pain. I had conventional surgery first which completely failed and really knocked me about. So I had a follow up embolisation. Been ok since. Are you worried your coils have migrated? Just get yourself a plain film you will clearly see if they have. If you are suffering from anxiety about it please don’t these coils are tiny no different from a surgical metal clip really. They aren’t moving!
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4 Comments
Thanks for the reply. I agree it's very rare. The guy who did mine said the chances were the same as a jumbo jet falling from the sky and hitting you.

I'm super happy it worked so well for you. Sounds like the majority of people have good outcomes with it. I'm not overly worried about the migration though I'm unfortunately one of those lucky few that have had a bad experience. I've had ongoing abdominal and lower back pain since insertion and a slew of weird and wonderful symptoms that i could only describe as autoimmune in nature. It's almost as if my body just doesn't agree with the coils themselves and is in a constant state of fighting them. To be honest I'm thinking of having them removed surgically.

Do you mind me asking how many coils you had inserted? They put around 10 in me running the length of gonadal vein all the way up to the renal
Sorry to hear that. What symptoms are you having? I have 8 nester coils made by a company called Cook Medical. Give it time before you make a decision. I dare so removal is an option probably easier just to take the whole gonadal vein out with the coils in. That said be careful you don’t want a urologist poking around stirring a hornets nest trying to find the coils and doing more damage.
Thanks for the reply. Yeah the surgeon was going to take the whole vein. His view is that it's not doing anything now anyway so it can't really hurt taking it out and may (or may not) fix the problem. He's done it once before, the coils were poking out of the vein and connecting to muscles causing issues in the other guy. That guy recovered but now has lingering ball pain.

My symptoms are bizzare and generalised. I get pain on the left side that kind of radiates around the coils and a weird pressure build up in the left hip and groin veins. I also experienced bad digestive issues, brain fog, weakness in my limbs, rash on my abdomen and shins, left wrist arthritis style pain, tinnitus, you name it really. I was fine before the embolisation. Fit and healthy.

Appreciate none of this makes any sense. That's why i think it may be a rare allergy / sensitivity response.  At least thats what I'm hoping. Dreading there is something structurally messed up like nutcracker syndrome that was missed ahead of the embolisation.

I have some nester coils but also have mreye made by cook and vortx made by Boston scientific.

You've had them in for about 9 years yeah and no issues?
Wow that’s very strange. Did it happen straight after the coils were put in? It’s certainly feasible to have them removed just weigh it up you don’t want them making it worse cutting the wrong veins etc.  Have you had an allergy test to see if you are allergic to any of the metals in the coils. That might be useful. Yeah I’ve had mine 9 years and so far no issues. Did it at least get rid of your varicocele?
Avatar universal
Yeah you can have the embolization repeated. I myself had a successful embolization  carried out 5 years ago and haven't had any issues since. I would definitely recommend it. I researched thoroughly before the surgery including whether I would still be able to have MRI scans. When I spoke to the urologist and radiologist they both said there will be no issues having MRI scans in the future. As for coil migration there is no danger of that happening after the vein has clotted and scarred up.
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Thats actually not true. There are instances of coil migratiom years after the fact. I have had this procedure done and i would not recommend it.
I should clarify that it is extremely rare but coil migration can happen after the procedure and is something that people should be aware of it.

m300 did you go through with the 2nd embolisation? If so what was the reason for the recurrence? Was it that the vein recanalised or did new collateral veins form years out?
How can coil migration occur in a fibrossed vein. It’s not possible. Show me your evidence. Coil migration is an early complication usually occurring in the first couple of days. Incredibly rare though usually as a result of incorrect placement. I myself have also had several mri’s and had no issues. I have Nester coils.
Rare but does happen. I spoke to a fellow that had it occur 5 years after the fact. Also see below link.

How have you been since embolisation? No issues?


https://www.google.com/url?sa=t&source=web&rct=j&url=http://smjournals.com/radiology/download.php%3Ffile%3Dfulltext/smrj-v1-1001.pdf&ved=2ahUKEwjrkr6zsp7bAhWITLwKHc6rB8EQFjAAegQIBxAB&usg=AOvVaw0TRtGz8essfeWViQSy8g2U
Avatar universal
YES, it is possible for these springs to dislodge and go to the heart/lung. (Potentially fatal) I study health care and this is the exact reason why im still uncertain as whether to get the embolization or not.

The fact that i see so many people having this procedure done, and the varicocele either reoccurring or not even going away in the first place! is bothersome. So my question is... what the hell is that spring doing sitting there in your body if going to no use at all, and who's performing these procedures?!

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Avatar universal
I have no idea about an MRI? Metail coil disloding - news to me..

Obiously less invasive then surgery - would want to go that path again.
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Avatar universal
Yes, it can be done twice.

How long did it take for your varicocele to go away after your first procedure?  Since its metal object, can you no longer have an MRI if needed?  What are the chances of the metal coil dislodging?  I heard it would transport to your lungs if dislodged but rare occurance.  

How was the procedure overall?  Would you recommend?

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