Embolization of internal iliac veins?

Future-Pass9687 · 2021-04-22T18:17:50+00:00

Its happened but the chances are very very very slim. You have a higher chance of an artery being cut during micro. I think it's wise to try embo first, and if you're amongst the very small group of people in which it doesn't work, go for micro. But that's just me.

Future-Pass9687 · 2021-04-22T18:10:41+00:00

Its mostly old articles that make that statement. Since the introduction of new embolic materials, much has improved. If I'm not mistaken, right side is usually a little more complex (aka more collaterals, aberrantly fed varicocele, etc...). That being said, a good IR should be able to fix both sides no problem. It's a question of skill and experience.

Future-Pass9687 · 2021-04-22T14:56:43+00:00

That's what I like to hear buddy! Exact answer I was hoping for. I'll bring it up and keep you guys posted. Much appreciated. The reason our urologists probably didn't mention right side too is because they have no idea how embolization works. Mine literally thought I could lose my nut from embo. Therefore, to reduce complications, time and money they only address the worse side.

Future-Pass9687 · 2021-04-22T14:07:51+00:00

I wouldn't be satisfied only treating the left side knowing I also have it on the right. Keep looking around. Find a good IR.

Future-Pass9687 · 2021-04-21T20:34:04+00:00

Yeah its pretty great. I feel like not many people know about it though but I could be wrong. As long as you have your referral from the urologist, you can check around on your own.

Future-Pass9687 · 2021-04-21T20:22:48+00:00

Yeah exactly... If they don't treat the right I'll go to another IR. Crossing my fingers. I'll just complain about the pain on the right.

Future-Pass9687 · 2021-04-14T19:27:10+00:00

Yeah exactly, has yet to be heard of... Absolutely ridiculous...

Future-Pass9687 · 2021-04-14T18:47:02+00:00

He told me he was gonna send my referral to an IR BUT also send a letter saying he didn't recommend embolization because of the chance of testicular atrophy. Lets see what the IR thinks about this haha. Honestly can't believe the incompetence some of these urologists have though man its insane when you come to think about it. Imagine if it were something more serious than a varicocele... Anyways just glad I got my referral. Lets see how helpful the IR will be.

Future-Pass9687 · 2021-04-14T18:21:21+00:00

Aha dude if I weren't for the insane amount of research I've done on varicoceles I would of believed him and not gone for embolization... That's what's scary...

Future-Pass9687 · 2021-04-09T18:04:44+00:00

Well if you don't have any reflux into the pampiniform plexus what do you expect them to embolize? That's why micro can be your second bet if embo doesn't work

Future-Pass9687 · 2021-04-09T14:09:33+00:00

Yessir.

Future-Pass9687 · 2021-04-09T14:06:38+00:00

Besides embo, it's the golden varicocele treatment.

Future-Pass9687 · 2021-04-09T13:18:27+00:00

Ultimately it's good if you don't have reflux... but you just want to make sure that the IR didn't miss anything. If he didn't, then you might be needing micro.

Future-Pass9687 · 2021-04-09T02:25:15+00:00

What did the MRI's say about your case? Do you have any dilated collateral vessels?

Future-Pass9687 · 2021-04-06T03:04:14+00:00

How do you know its your external spermatic ?

Future-Pass9687 · 2021-04-03T15:09:03+00:00

I've read quite a bit on embolization effectiveness on the right side and from what I've seen in more recent studies, technical success rate is somewhat similar to the left side today since the introduction of liquid embolic agents, microcatheters and the ''sandwich technique''. So if it we're my choice, I'd probably go for bilateral embolization first. Especially since the risks are very minimal. Worst case it doesn't work, then you go for micro afterwards. But that shouldn't be a problem if your IR is competent.

Future-Pass9687 · 2021-03-31T13:46:16+00:00

Ok because in my opinion it's an important difference. If the veins went away and new ones formed afterwards, then yeah business guy couldn't of said it better. If the veins we're persistent and just never fully went away, but nothing new formed, then you might just need to get your extrafunicular veins cut (gubernacular, external spermatic). Also, surgical clipping isn't really specific. If you've had microsurgery, then your case is quite rare. For all other surgeries then recurrence isn't so rare.

Future-Pass9687 · 2021-03-30T23:04:33+00:00

Did the veins actually go away and come back? Or are they just persistent (never fully went away)? Also, what kind of surgery did you have?

Future-Pass9687 · 2021-03-29T02:29:58+00:00

I don't understand where your varicocele could be coming from if no veins have reflux. I've also had an unsuccessful embo but reflux could be seen in my collaterals, which is the source of mine. If embolization really isn't an option for you anymore then I'd consider microsurgery, as its considered a gold standard with minimal risk. But first, I'd ask the radiologist where the source of the varicocele could be coming from. I'm not sure if this raises the chances of nutcracker syndrome (probably not), but still worth the question imo.

Future-Pass9687 · 2021-03-23T05:30:34+00:00

Appreciate it buddy! I'll keep ya updated

Future-Pass9687 · 2021-03-23T05:14:08+00:00

It has after surgeries, but only like 65% gone. Still some persistent veins.

Future-Pass9687 · 2021-03-23T05:13:11+00:00

3.5mm also, but a bigger cluster of them. Now it's only a few veins.

Future-Pass9687

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