South Florida Vascular Associates South Florida Vascular Associates

Monday, March 16, 2015

Gary's Story: Varicoceles

30 Minute Minimally Invasive Procedure Enables Man Suffering from Painful Varicoceles to Return to Active, Pain-Free Lifestyle

Five years ago in 2009, at age 33, Gary S. began suffering from severe discomfort in his left testicle. “I wasn’t sure what the pain was from and I hate going to doctors, but I was in so much discomfort, I went to see a urologist in Tampa where I was living at that time”, said Gary. The urologist diagnosed Gary with a varicocele, a relatively common condition that affects approximately 10 percent of young men usually during the second or third decade of life.

Varicoceles are pain and swelling of the testicles caused by tangled blood vessels and weak defective valves in the scrotum resulting in blood pooling.  When the valves in the testis work properly, they only allow the blood to flow away from the testicle, but sometimes these one-way valves can fail and reverse the flow of blood. Sometimes, varicoceles cause no symptoms and are harmless. But sometimes a varicocele causes pain, testicular atrophy (shrinkage), or low sperm count resulting in fertility problems.

The urologist told Gary that his varicocele was not bad and that he should simply wear supportive underwear, take advil, and ice his testicles as needed. While there are surgical and minimally invasive procedures that can correct varicoceles, Gary was told it was not necessary in his case.

As an avid runner, martial arts lover and tri-athalon participant, Gary was forced to give up all of his daily activities because the pain became unbearable. He was no longer able to live the active life he once enjoyed.  He worked as a contractor, frequently on his feet and worked outdoors in the Florida heat and humidity which was also very difficult because the heat and humidity caused extreme discomfort in the testicle. Some men describe varicoceles as feeling like a bag of worms in the scrotum.

In June of 2014 Gary knew it was time to be proactive with his medical care and seek a solution that would help to alleviate his pain. He did some research on the internet about varicoceles and found Dr. William Julien, Medical Director at South Florida Vascular Associates (SFVA). Dr. Julien is a well-known and respected interventional radiologist who performs a minimally invasive procedure called varicocele embolization. Varicocele embolization is performed at SFVA in their in-office, out-patient facility.  Gary was very interested in what he read and immediately made an appointment to see Dr. Julien.

Varicocele surgery is often performed by a urologist using traditional open surgery.  The surgery is done in a hospital under general anesthesia, with an incision made in the skin above the scrotum and cutting down to the testicular veins. The veins are then closed with sutures. Recovery from this type of surgery can take two to three weeks. Gary was not interested in the surgical approach.

Upon examination, Dr. Julien confirmed that Gary did have a varicocele and that he was a candidate for varicocele embolization. Dr. Julien explained that the procedure is done by inserting a small tube with a catheter into the femoral vein in the groin then painlessly guided it into the abdomen and the varicocele using the guidance of x-ray imaging. The varicocele is then closed off by plugging it with small metal coils and using a special medication that slows the blood flow, causing the blood to clot and seal the vein. The coils remain in place to keep the vein permanently sealed. The procedure takes 30 minutes and the patient goes home a few hours later with only a band aid at the puncture site. Patients can immediately resume their non-exertional activities.

2 weeks later Gary had a very successful varicocele embolization. “The surgery was easy and the staff at South Florida Vascular Associates is wonderful. I can finally enjoy my life again”, says Gary. He is no longer in pain, is able to take long walks on the beach with his girlfriend and has also begun an exercise routine. He is hoping to resume running again too. Gary highly recommends this procedure to anyone who suffers from testicular pain related to a varicocele. “I waited 5 years before I got the help I needed, says Gary, but fortunately I found the right doctor and I’m back on track enjoying my life, free of pain”.

Tuesday, March 10, 2015

Do You Have Fibroids and Plan to Have a Hysterectomy? Here’s What you Need to Know

Many women diagnosed with fibroids are often told by their doctors that the best treatment is a hysterectomy however, if you suffer from fibroids, a hysterectomy isn't the only option; in fact a hysterectomy should perhaps be your last option.

 A non-invasive treatment, uterine fibroid embolization (UFE) has proven to be a safe and effective option. UFE is a minimally invasive procedure in which the blood flow of the uterus is intentionally reduced causing the fibroid tumors to shrink. It alleviates or improves fibroid symptoms 90% of the time. UFE is performed by making a tiny nick in the skin in the groin and inserting a tube, known as a catheter, into the femoral artery. Using x-ray imaging, the catheter is guided through the arterial system and into the arteries supplying the uterus. Tiny particles, the size of grains of sand are then injected into the uterine arteries to block the blood flow which starves and destroys the fibroid.

At South Florida Vascular Associates our Board Certified endovascular surgeons, Dr. William Julien and Dr. Curtis Anderson have performed thousands of uterine fibroid embolizations in our outpatient facility, conveniently located in our office and it does not require an overnight stay. Pain-killing medications and drugs that control swelling typically are prescribed following the procedure to treat cramping and pain. Many women can resume light activities in a few days and the majority of women are able to return to normal activities within seven to ten days.

Benefits of UFE over hysterectomy
No general anesthesia
Abdominal incision is not required.
There is little to no blood loss, so there is no need for blood transfusions.
All fibroids may be treated at the same time.

About Fibroids
Fibroids are benign, non-cancerous growths in or on the walls of the uterus, or womb. They can range from less than an inch in diameter to more than six inches. African-American women and those with a family history are more likely to have fibroids than women of other racial groups. Fibroids affect close to 50 percent of African-American women over the age of 40 and are prone to having larger and more fibroids. Fibroids can also develop at a younger age.
Fibroids also affect more than 40 percent of women over the age of 40 and are often found in women immediately prior to menopause (ages 45-50) because they have more unopposed estrogen which causes them to experience rapid growth of their fibroids.

Many fibroids cause no symptoms and are only discovered when a woman has a routine pelvic examination. However, if you do experience fibroid symptoms, medical attention is necessary. Symptoms may include:
Heavy, prolonged monthly periods, sometimes with clots
Fatigue, secondary to a low blood count
Pain or pressure between the hip bones or in the back of the legs
Pain during sexual intercourse
Frequent need to urinate
Constipation or bloating
An enlarged belly

If you are experiencing any of the symptoms above, we invite you to call our office today for a consultation to determine whether UFE is an option for you.