April 14, 2025
Varicoceles are a common cause of male infertility and testicular discomfort, affecting around 15% of men. Fortunately, treatment options like varicocele embolisation and surgery can relieve symptoms and, in many cases, improve fertility outcomes. But one of the most frequent questions patients ask is: “Will my varicocele come back after treatment?”
In this blog, we explore what the evidence says about recurrence rates, what causes a varicocele to return, and how you can minimise the chances of needing further treatment.
Understanding Varicocele Recurrence
A recurrence means the varicocele reappears after it has been treated. This can happen months or even years after the initial treatment, though in many cases, patients remain symptom-free.
The recurrence rate largely depends on the type of treatment used and the experience of the treating clinician. Two main treatment options are:
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Varicocele Embolisation (performed by an interventional radiologist)
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Surgical Ligation (performed by a urologist or surgeon)
Recurrence Rates: Embolisation vs. Surgery
Multiple studies have compared recurrence rates between embolisation and surgery. While outcomes can vary, the current literature suggests:
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Varicocele embolisation has a recurrence rate of approximately 4–11%
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Surgical ligation (particularly open or laparoscopic techniques) can have recurrence rates of 9–16%
One of the reasons embolisation may offer lower recurrence is the ability to visualise and block all affected veins during the procedure using contrast dye and fluoroscopy. This reduces the likelihood of missing collateral veins that can continue to feed the varicocele.
Why Do Some Varicoceles Come Back?
Recurrence may be due to:
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Incomplete treatment – some feeding veins may not be fully blocked or tied off
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Collateral circulation – new or previously unnoticed veins begin feeding the varicocele
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Technical issues – such as coil migration or suboptimal technique
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Patient-specific anatomy – certain vein patterns can make treatment more complex
Minimising the Risk of Recurrence
While no treatment can offer a 100% guarantee against recurrence, choosing an experienced interventional radiologist and undergoing thorough diagnostic imaging beforehand can significantly reduce the chances.
If you've previously had surgery and the varicocele has returned, embolisation is often the preferred next step because it’s minimally invasive and allows a different access point to the problem.
What to Do If You Suspect a Recurrence
If you notice the return of symptoms such as a dull ache, heaviness in the scrotum, or changes in fertility, speak with your doctor or interventional radiologist. An ultrasound can confirm whether the varicocele has returned and guide next steps for treatment.
Final Thoughts
Varicocele recurrence is possible — but with modern embolisation techniques, the risk is relatively low. The key is early detection, expert care, and ongoing follow-up. If you're considering treatment or have had a previous recurrence, book a consultation with Northern Beaches Interventional Radiology to explore your options.
