Idiopathic varicoceles: feasibility of percutaneous sclerotherapy.

Abstract

Percutaneous retrograde venography was performed in 717 patients with a left-sided idiopathic varicocele. In 674 (94.0%), testicular (internal spermatic) vein insufficiency was proved by contrast medium reflux from the left renal vein into the testicular vein, down to the pampiniform plexus. The different venographic patterns of the testicular veins were classified into seven basic types. Five of these, comprising 624 patients, had incompetent or missing valves all along the trunk of the testicular vein. In 554 of the 624 (88.8%), sclerotherapy was performed, but such treatment was possible in only three of 50 patients with a competent orifice valve bypassed by an insufficient collateral (type IVb). In 43 of the 717 patients (6.0%), no insufficient vein could be found at all (type 0). The mean fluoroscopy time was 4.4 minutes. There were no serious complications associated with venography or sclerotherapy, and the initial recurrence rate was 9.8%. Percutaneous sclerotherapy is therefore a simple, safe, and effective treatment of testicular vein insufficiency and is suitable for almost 80% of patients with varicoceles.

Varicocele percutaneous embolization outcomes in a pediatric group: 7-year retrospective study

“…Although the recurrence rate of laparoscopic procedure is reported to be lower than inguinal varicocelectomy and embolization (0-2 % compared to 15 % in inguinal and 7-16 % in embolization) [20][21][22][23][24], this procedure presents higher complication rate compared to embolization [21,25]. Contradictorily, Silvera et al reported that laparoscopic procedure has no complications; however, this study presented a limited cohort of 20 patients.…”

Percutaneous Treatment of Varicocele

“…In 1978 Iaccarino [20] first described the possibility of combining the diagnostic procedure of spermatic venography with definitive occlusion of the spermatic vein. In the past 20 years, several authors have published results of percutaneous occlusion of varicocele [21,22] and percutaneous transcatheter embolization using various embolic materials for the treatment of varicocele is now widely performed [16,17]. Since 1984 we have been convinced that retrograde phlebography plays a precise role in better defining the anatomy of the internal spermatic veins [14].…”

Efficacy and Safety of Two Different n-Butyl-2-Cyanoacrylates for the Embolization of Varicoceles: A Prospective, Randomized, Blinded Study

“…Varicoceles were classified according to an adapted version of Dubin and Amelar [26] in subclinical: grade 1 (small), grade 2 (moderate), and grade 3 (large). Phlebographic classification of the left spermatic vein insufficiency was done according to the Bähren et al [27,28] types and for the right spermatic vein according to Siegel et al [29].…”