[Dr. Kim Gun-woo's Intervention Clinic]
Varicocele , which occurs in the male scrotum , can be a cause of male infertility, so treatment is necessary if it is stage 3 or higher.
Today, I will fact-check whether the terms "radiation" and "radiation therapy," which are often attached to varicocele embolization—a non- surgical treatment for varicocele—are actually accurate.
#TesticularPain TesticularFever Causes Varicocele
◆Fact Check 1: Is Embolization Radiation or Radiation Therapy? 'NO'
One of the biggest concerns for patients when consulting about varicocele embolization is radiation. Some online sources refer to embolization as "radiation therapy" or describe it as if strong radiation is being directed at the genitals throughout the entire procedure.
However, this is not an accurate description. This is because embolization is not radiation therapy, which involves introducing radioactive material into the body for treatment. The term "radioactivity" is also not appropriate to apply to this treatment.
Embolization is an 'interventional' treatment that uses X-ray examination from an angiography device to confirm the position of a catheter inside a blood vessel. X-rays are emitted only while the equipment is operating, and no radiation remains in the body after the treatment is completed.
The total procedure time and the time spent using X-rays are not identical. At Mint Hospital, the embolization procedure takes approximately 15 to 20 minutes. During this time, X-rays are not used for disinfection, local anesthesia, vascular entry, or the preparation and placement of the catheter and embolization material. In particular, Mint Hospital uses brief fluoroscopy to confirm the location of the blood vessel and saves necessary scenes to reduce repeated shots, keeping the X-ray imaging time to about 5 seconds. Additionally, applying principles such as low-dose pulsed fluoroscopy, limiting the irradiation range, and minimizing magnification can reduce unnecessary exposure. Medical staff with sufficient experience are also better able to quickly identify the vascular structure and reduce unnecessary catheter manipulation and imaging.
Moreover, embolization is not a cutting-edge treatment that appeared overnight, but rather a therapeutic method that has developed over more than 50 years and accumulated clinical data. The European Society of Cardiovascular Interventional Radiology (CIRSE) also evaluates varicocele embolization as an effective minimally invasive treatment and provides separate standard clinical guidelines. CIRSE explains that varicocele embolization has been performed since the late 1970s, and since then, catheters, embolization materials, imaging equipment, and surgical techniques have continuously advanced. Embolization is utilized even more actively in the United States and Europe.
◆Fact Check 2: Is treatment performed by focusing X-rays on the testicular area? 'NO'
In addition, imaging during varicocele embolization is used to visualize the central vein through which the catheter passes, as well as the renal vein, testicular vein, and pelvic venous structures. It does not involve focusing radiation directly onto the testicle for therapeutic purposes.
Moreover, radiation reduction technology in angiography equipment has also changed significantly compared to the past. A study published in 2025 compared 113 patients who underwent varicocele embolization between 2020 and 2024 using older and newer angiography equipment. The results showed that radiation-related indicators decreased by as much as 64–71% in equipment utilizing the latest dose reduction technology. Even though the procedure and fluoroscopy times were similar, the actual radiation dose varied significantly depending on the generation of the equipment.
Previous studies have also shown that the radiation dose from varicocele embolization could be significantly reduced by applying low-dose settings and a reduced irradiation range. Therefore, there are limitations to directly applying radiation data from equipment and procedures from 20 to 30 years ago to the current treatment environment.
#Mint Hospital Chief Director Kim Gun-woo (Specialist in Interventional Radiology)
◆Fact Check 3: Embolization Not a 'Simple Treatment'... A Specific Field of Vascular Treatment
Furthermore, viewing embolization, a minimally invasive vascular treatment, simply as a “simple procedure for those who find surgery burdensome” is an oversimplification of modern interventional therapy.
Embolization is already being utilized as a core treatment technology for various severe diseases. In liver cancer, transarterial chemoembolization (TACE), which involves using a catheter to locate the hepatic artery supplying the tumor and administering anticancer drugs and embolizing agents, is one of the representative treatment methods. The U.S. National Cancer Institute also describes TACE as a major treatment used for liver cancers that are difficult to surgically resect. In cerebral aneurysms, endovascular coil embolization—which involves closing the aneurysm using coils inside the blood vessel—has also established itself as a key treatment pillar, alongside open-skull clip surgery.
Varicocele embolization is also a treatment that has evolved within the same trend of interventional medicine. As a primary treatment option for varicocele that patients can choose after verifying sufficient information, it offers significantly lower side effects compared to surgery, which carries risks of complications from general anesthesia, hydroceles, and testicular atrophy.
Written by Kim Gun-woo, Director of the Mint Hospital Intervention Center (Specialist in Interventional Radiology)
https://n.news.naver.com/mnews/article/396/0000754713?sid=103
