Die Behandlung der idiopathischen Varikozele durch transfemorale Spiralokklusion der Vena testicularis sinistra

Abstract

The standard surgical procedures for the treatment of idiopathic varicocoeles are unsuccessful in, or show a recurrence rate of, up to 25%. An alternative method is transcutaneous embolisation using the Seldinger catheter technique. For this technique of transcutaneous catheter embolization, we have used the Gianturco spiral. The embolization is carried out following diagnostic transfemoral phlebography of the left testicular vein, which also provides the indications or contra-indications for this procedure. The method has been used on nineteen patients with varicocoeles requiring treatment; amonst these were three patients who had had unsuccessful operations. Follow-up period so far is six months. In all cases the varicocoele had disappeared, including one patient who had suffered complications following previous surgery.

Liquid and Solid Embolic Agents in Gonadal Veins

“…More than 30 years ago, coils were introduced by Thelen et al [53] and they showed to be effective in varicocele treatment. Coils-embolization is the most commonly used technique, due to coils simplicity in handling and availability [54].…”

“…Initially, the original 0.038 inch Gianturco coils were used; subsequently, fibered stainless-steel coils and platinum coils were developed, ranging from 0.035 to 0.038 inches and oversized up to 20%. Coils can be pushable or detachable, the latter improve correct placement [53]. During embolization procedures, coils are first deployed through the microcatheter as distal as possible and up to the inguinal canal.…”

Advances in Diagnostic Urology

“…The eauses are incomplete operation or variations of the retroperitoneal venous system (Riedl 1979). 8) ean be performed immediately after phlebography for treatment or labeling (Thelen et al 1979). Various methods are available for this: I) Transfemoral phlebography (Ahlberg et al , 1966Janson and Weißbaeh 1978;Ried11979;Strecker and Sinagowitz 1979); 2) serotal phlebography (Heising et al 1979); 3) intraoperative visualization from the exposed gonadal vein.…”

Therapiealternativen bei idiopathischer Varicocele testis

“…Scharf davon zu trennen ist das Risiko der exakten Plazierung bzw. die beschriebene Komplikation von in die Lunge oder Nierenvene disloziertem oder gewandertem, festem Embolisationsmaterial (10,33,41). Auf der anderen Seite fehlen Langzeitergebnisse über Fremdkörperreaktionen abgeworfener fester Embolisationsmaterialien und über die Effektivität dieser Embolisationsmethode, da nur die Spermatikavene und nicht ihre Kollateralen thrombosiert werden können.…”