Mr. Daniel Johnson, B.Sc.
Well, both are bad options. Don't fall for the surgery vs embolization marketing tactic. Embolization is typically sold as a "non-surgical" alternative to varicocelectomy, with only a small "small incision", "no general anaesthetic", and on an "out-patient bases". Hmmm, that sounds great, right?
Hmmm, I think we forgot something... Oh yeah, Results! Will it treat your varicocele? Will it improve your fertility and help you attain successful pregnancy? Will it cure your pain? Well, as it turns out the answer to all of these is "likely no", and "we're not certain". The science is really lacking on embolization.
But, you know what is certain? The risks of embolization.
Embolization is a radiological procedure, that means x-ray exposure, and x-ray dye injection to help visualize the veins. It also has a high varicocele recurrence rate--up to 35% for right-sided varicoceles. 10-35% chance of hydrocele formation. Oh and my favorite one: Coil migration resulting in testicular loss... And many more risks.
VARICOCELE SURGERY IS NOT A CURE
It's important to know that varicocele surgery is not a cure for varicocele. It's simply a treatment method, and not an effective one. Consider: Varicocele surgery, is not effective for pain relief, and only has an NNT of 7 for improving pregnancy rates (14% improvement). Also, consider:
WHY IS SURGERY THE ONLY TREATMENT OPTION?
Well, no, surgery is not the only treatment option for varicocele. It is a little confusing at first, because when you search for varicocele treatment methods, all that you see are "Surgery", "Surgery or Embolization", or "Do Nothing". Not surprisingly, 99% of the scientific literature is also on surgery, embolization, or doing nothing. Very few scientists seem concerned with the alternatives. It does seem odd at first, but consider that surgeons and radiologists charge anywhere from $8,000 to $20,000 for a one hour procedure, which translates to an over $300,000,000 market per year, in just the United States. The money dictates the content, and the scientific research. Not a conspiracy, just how money, marketing and research work. Simply, marketing and research require financing to function. But, you have to realize that this also heavily skews pretty much everything in favor of surgery.
WHY DOES VARICOCELE REDEVELOP AFTER SURGERY?
Well, simply because surgery treats the symptom of swollen veins, and does Not treat the root cause of varicocele. I've studied the 1% of the science that talks about alternatives to surgery and embolization, and the science shows that lifestyle is very important [2, 3]. Moreover, when it comes to testicular health, fertility and pain, there is a lot that you can and should be doing. For example, if you have infertility and sit all day for work--should you get varicocele surgery, or improve your lifestyle? If you have a poor diet, should you have surgery, or correct your lifestyle? If you have very high stress, should you have surgery, or correct your lifestyle? You know, I think it's pretty straightforward, but the over-fixation on surgery or nothing mixes us up.
Here are some examples of controllable varicocele risk factors (the root causes): We know that taller men experience higher rates of varicoceles, but this isn't necessarily because of their height. Actually, it is likely that taller men simply have worse posture, which is a controllable varicocele risk factor. We also know activity type is a risk factor for varicocele: E.g. men who play basketball experience higher rates of varicocele than those who swim. We also know that bowel health effects varicocele: E.g. constipation and irregular bowel movement are positively associated with varicocele. We know that the percentage of men with varicocele increases in countries the modernize (e.g. increased sedentary lifestyle, change in diet, change in activity type, increased postural imbalances, etc.) So, really, in conclusion, there are many controllable varicocele risk factors, and focusing on surgery--as the only solution, is really just misleading, and the reason for why varicocele redevelops after surgery.
“High Rate of Success”: Here is something that I find absurd: Many infertile couples are advised that surgery has a “high rate of success”, and they go for it thinking that they’ll have a successful pregnancy. But, really, they’re ill-advised. It’s important to ask “success at what?” Turns out that the word “success” has absolutely nothing to do with pregnancy—it simply means that the procedure was successful at removing the veins without causing major damage. Now, imagine telling that to an infertile couple who are have committed to dish out $15,000, and undergo the surgical risks—with their main goal being successful pregnancy...
Here is the correction again: The best results for surgery state that for every 7 men who undergo surgery, only 1 addition pregnancy is attained. That’s 14%. The natural conception rate of infertile couples over a year is 34%, with varicocele surgery, these same couples will have a 37% to 38% chance of successful pregnancy. And these are the best results. Actually, much of the scientific literature is showing mixed results. It is no wonder that varicocele surgery is the most controversial topic in the field of andrology.
Just Think About It:
Embolization Is Not an Alternative: Now, what about embolization? It is a great “non-surgical” “alternative”, right? Wrong. The best results for embolization state that for every 17 men who undergo embolization, only one additional pregnancy is attained. The supporting research is low quality (even lower quality than surgery). Embolization may not be effective at all. And, embolization is not a low-risk procedure. Worth the risks? I think not.
High Risk, Low Reward: Come on guys, they’re serving us an inconclusive 6-14% improvement in pregnancy rate, and we’re eating it up like it’s a cure. Surgery and embolization are not a cure. They are far from it. They are simply high-risk and costly treatment methods for varicocele.
No 100% Cure: Is there a 100% cure for varicocele? Unfortunately no, there isn’t. Surgery is not a cure. Embolization is not a cure. There is no medication for curing varicocele. No herbs. No supplements. And, not even my natural treatments or yoga. There is no 100% cure. However, my treatments are likely the most effective treatment option. I have developed my treatments from personally helping thousands of varicocele clients. Right now, my treatments are good enough to help completely cure varicocele pain, restore fertility, reduce varicocele swelling size by 40-60%, and prevent varicocele progression. That’s pretty good, considering the alternatives, and that my treatments don’t take more than a few minutes per day, and are actually good for your health.
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