Percutaneous Sclerotherapy of Varicoceles—an Alternative to Conventional Surgical Methods

Porst, H.; Bähren, W; Lenz, Martin; Altwein, Jens E.

doi:10.1111/j.1464-410x.1984.tb07168.x

Cited by 58 publications

(35 citation statements)

References 17 publications

(8 reference statements)

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“…These findings were supported by many radiographic studies, where they observed and identified these ana tomical arrangements, but these were only sporadic ob servations [11][12][13].…”

Section: Intraoperative Antegrade and Retrograde Spermatic Venographysupporting

confidence: 63%

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Anatomy of the Venous Drainage of the Human Testis: Testicular Vein Cast, Microdissection and Radiographic Demonstration

Wishahi¹

1991

Eur Urol

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“…These findings were supported by many radiographic studies, where they observed and identified these ana tomical arrangements, but these were only sporadic ob servations [11][12][13].…”

Section: Intraoperative Antegrade and Retrograde Spermatic Venographysupporting

confidence: 63%

“…The division of the testicular vein into medial and lateral branches was observed in many radiographic reports [9,[11][12][13] and was reported by us in a previous study [10]. According to this finding, we believe that the ideal site for testicular vein interruption should be below the site of the bifurcation.…”

Section: Discussionmentioning

confidence: 65%

Anatomy of the Venous Drainage of the Human Testis: Testicular Vein Cast, Microdissection and Radiographic Demonstration

Wishahi¹

1991

Eur Urol

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“…16 But several reports supported the disadvantage of embolization due to the exposure to radiation and significant recurrence rates, in addition to the potential risk of vessel perforation and embolus migration. 21,22 At our department three methods of surgical ligation for left varicocele were performed, and the current data clearly demonstrated the minimal invasiveness of subinguinal microsurgical technique compared to high ligation and laparoscopic procedure. As Table 2 indicates, the operation time and hospitalization days in the subinguinal group are shorter than those of the other two procedures.…”

Section: Discussionmentioning

confidence: 99%

Minimal invasiveness and effectivity of subinguinal microscopic varicocelectomy: a comparative study with retroperitoneal high and laparoscopic approaches

et al. 2005

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Aim : The standard management of varicocele repair is the subject of ongoing controversy. We retrospectively evaluated three surgical methods of varicocele treatment to determine the minimally invasive and most effective procedure. Methods : We performed 144 varicocelectomies on infertile patients with left clinical varicocele. Of the patients, 50 were treated with retroperitoneal high ligation under lumbar anesthesia, 33 with laparoscopic ligation under general anesthesia, and 61 with subinguinal microscopic ligation under local anesthesia. Operative time, hospital days, and clinical outcomes were compared between these techniques. Results : The operating time and hospitalization period required for subinguinal microscopic ligation was significantly shorter compared to those for the other procedures. All patients treated with subinguinal microscopic ligation could achieve normal activity as soon as they returned to their rooms. Postoperative complications were observed in five (10.0%) cases treated with high ligation and three (9.1%) laparoscopic cases, but were not observed after the subinguinal procedure. There were six cases (12.0%) of recurrence in the high ligation group and six (6.1%) in the laparoscopic group, but none in the subinguinal group. Sperm density was significantly improved in all procedures postoperatively, but sperm motility was not improved. The two-year pregnancy rate calculated by the Kaplan-Meier method was 35.8% for high ligation, 40.4% for laparoscopic ligation and 50.9% for subinguinal microscopic ligation, although there were no statistical differences between the three groups. Conclusion : We concluded that subinguinal microscopic varicocelectomy could be a minimally invasive procedure compared to the other two techniques and a worthy method for treating male infertility due to clinical varicocele.

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“…Among the current surgical procedures for treatment of PCS, laparoscopy and transcatheter embolotherapy have been used with good symptomatic relief, but with a tendency for later recurrence of pelvic pain in some cases (4 -9). Since anatomical venous variations are common (10,11), it is important to know the anatomy of these vessels for treatment planning (12,4). The diagnosis of PCS has usually been suggested by venography and ultrasound with Doppler (13)(14)(15)(16)(17)(18)(19), but ultrasound does not depict the gonadal veins.…”

mentioning

confidence: 99%

Ovarian veins: Magnetic resonance imaging findings in an asymptomatic population

Nascimento

Mitchell

Holland

2002

Magnetic Resonance Imaging

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Purpose: To evaluate the magnetic resonance (MR) venographic appearance of the ovarian veins in a healthy population, correlated with surgical findings. Our data can be used as a basis for comparison to patients with suspected pelvic congestion syndrome (PCS). Materials and Methods:We retrospectively reviewed exams of 22 women who had MR angiography for potential renal donation evaluation (age range, 19.3-60.5 years; mean, 38 years). We evaluated the diameter of the ovarian veins on dynamic multiphasic postcontrast coronal images, the phase of contrast appearance in these veins, the apparent direction of flow, and the presence of ovarian or pelvic varices. Surgical correlation was obtained in 12 patients. Clinical charts were reviewed and patients were asked about symptoms of chronic pelvic pain and the number of their children. Results:Of the 22 exams, 21 left gonadal veins were identified. Passive reflux from the left renal vein into the left gonadal vein was suggested in eight exams (38%). These veins had a mean diameter of 6.4 Ϯ 1.6 mm, significantly larger than 4.5 Ϯ 1.3 mm for the other 13 left gonadal veins without reflux (P Ͻ 0.005). The right gonadal vein was identified in 8 of 22 women, with a mean diameter of 4.4 Ϯ 0.5 mm. No patient reported symptoms of chronic pelvic pain. Conclusion:Passive reflux from the left renal vein to the left gonadal vein can occur in asymptomatic women. Diagnosis of PCS depends heavily on appropriate clinical history.

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Percutaneous Sclerotherapy of Varicoceles—an Alternative to Conventional Surgical Methods

Cited by 58 publications

References 17 publications

Anatomy of the Venous Drainage of the Human Testis: Testicular Vein Cast, Microdissection and Radiographic Demonstration

Anatomy of the Venous Drainage of the Human Testis: Testicular Vein Cast, Microdissection and Radiographic Demonstration

Minimal invasiveness and effectivity of subinguinal microscopic varicocelectomy: a comparative study with retroperitoneal high and laparoscopic approaches

Ovarian veins: Magnetic resonance imaging findings in an asymptomatic population

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