Varicocele
Close the faulty vein behind varicocele through a 1–2 mm incision — for comfort and fertility.
OVERVIEW
Dr Marios Agathangelou performs varicocele embolization in Nicosia and Limassol, Cyprus — covered by GESY, €0 for GESY beneficiaries. Varicocele embolization treats the enlarged veins of the scrotum from the inside. Through a 1–2 mm incision at the neck or groin, a catheter reaches the faulty testicular vein and seals it with coils or embolic agent.
Blood reroutes through healthy veins, pressure falls, and the dragging discomfort eases. It is an established alternative to surgery for pain and for fertility-related indications — with no surgical incision in the scrotum.
WHO IT’S FOR
- Varicocele with aching or dragging discomfort
- Fertility work-up where varicocele is a factor
- Recurrence after previous surgery
BENEFITS
GESY COVER
The procedure is fully covered by GESY. It is done as an inpatient admission, and that admission includes the treatment — you pay nothing for the procedure.
Separately, the outpatient visit — the initial assessment, where it is decided whether the treatment suits you — may carry a small co-payment, usually €0–10, as any specialist visit within GESY does.
The co-payment is per activity, and it stops once your total co-payments for the year reach €150 — past that you pay nothing. Some categories of beneficiary have different limits.
Both need a valid referral, from your personal doctor or from a specialist.
Outside GESY, or with private insurance? We provide the documentation your insurer asks for, and a clear cost estimate at your consultation, before you decide anything.
WHEN TREATMENT IS WORTH IT
Not every varicocele needs treatment. The accepted reasons are persistent pain or heaviness, subfertility when it comes with abnormal semen findings, arrested testicular growth in adolescents, and recurrence after previous surgery. A varicocele found by chance, which causes no pain and affects nothing, is usually watched — not treated.
AND FERTILITY?
It is why many men come, and it needs honesty. Embolization often improves semen parameters, and a substantial share of couples conceive afterwards. That does not mean embolization was the cause, nor that it will happen for you: subfertility usually has more than one factor, and assessment is done together with a urologist or fertility specialist. We do not promise a pregnancy.
RISKS
The procedure is done through a single puncture in a vein, with no scrotal incision. Mild groin or scrotal discomfort and a bruise at the entry point are common in the first days and settle on their own.
Rarely: inflammation along the treated vein, a reaction to the contrast dye, and a coil moving out of position. The last is recognised during the procedure itself, because flow is watched continuously on X-ray throughout.
Occasionally the vein cannot be reached and the procedure is stopped rather than forced. That is not a complication, and nothing has been lost — the surgical route remains open.
The most important difference from surgery is not a complication — it is recurrence. Where recurrence is checked properly with ultrasound rather than by examination alone, it clusters around 6.25% — about 1 man in 16. That is broadly comparable to, or slightly higher than, standard surgical ligation.
Recurrence is not a dead end. Embolisation is repeatable and well tolerated, so if the varicocele comes back it can simply be treated again — nothing about the first procedure closes off a second.
Against that, embolisation carries fewer complications overall than the operation, and clearly less hydrocele — the collection of fluid around the testicle that is the commonest complication of surgery.
Which of the two matters more depends on your case. We will discuss it before you decide.
COMMON QUESTIONS
Dr Marios Agathangelou, an interventional radiologist, performs varicocele embolization in Nicosia and Limassol. It is covered by GESY — €0 for GESY beneficiaries.
Usually not. A varicocele found by chance that causes no pain and affects nothing is generally watched rather than treated.
It often improves semen parameters, and many couples conceive afterwards — but subfertility usually has more than one factor and we cannot promise a pregnancy. This is assessed with a urologist or fertility specialist.
It is done with local anaesthesia and light sedation through a small puncture at the neck or groin. Afterwards there can be a dull ache for a few days.
Usually one to two days. There is no hospital stay.
Recurrence after embolization is uncommon over long follow-up, and embolization also works where a previous operation has failed.
No surgical incision is made — access is through a needle puncture, so there is no scar in the groin or scrotum.
Nothing, if you are a GESY beneficiary. GESY covers the procedure in full: it is done as an inpatient admission, and that admission includes the treatment. The outpatient visit where it is decided whether the treatment suits you may carry the usual small GESY co-payment, and you need a valid referral from your personal doctor or from a specialist. Outside GESY, or with private insurance, you get a clear cost estimate at your consultation, before you decide anything.
SOURCES
Clinical statements on this page follow the CIRSE Standards of Practice on varicocele embolisation. They describe the treatment in general; they are not advice about your case.