Post‐surgical recurrent varicocele: efficacy of internal spermatic venography and steel‐coil embolization

Abstract

Internal spermatic venography allowed a precise anatomical definition of the recurrent varicocele and the use of steel-coil embolization provided satisfactory improvements in sperm quality and paternity.

Treatment of Varicocele for Male Infertility: A Comparative Study Evaluating Currently Used Approaches

“…Varicocelectomy is the most frequently performed operation for the management of male infertility [7, 8, 10]. The principle of the surgical treatment is to obstruct the dilated veins that drain into the pampiniform plexus [9].…”

“…With the evolution and progress of interventional radiology, less invasive methodology has entered the field presenting alternative choices of treatment to open surgery. Percutaneous embolization with coils has been used by many investigators [8, 12, 17]. …”

Simultaneous Microsurgical Spermatic Vein Ligation and Sclerotherapy

“…Some authors prefer retrograde venography and sclerotherapy for treatment of postsurgical recurrent varicocele. Clinical studies, however, demonstrate only limited success rates of retrograde embolization of 78–85% [18, 19]in these cases. Our results demonstrate that microsurgical varicocele ligation can be combined effectively with antegrade sclerotherapy.…”

Is Selective Internal Spermatic Venography Necessary in Detecting Recurrent Varicocele after Surgical Repair?

“…However, these techniques have a recurrence rate that ranges from 5 to 45% [6, 7]. These recurrences are usually the result of residual venous communications from mid retroperitoneal or low inguinal parallel collaterals [8, 9]. Radiologic embolization techniques are also associated with high recurrence rates ranging from 2 to 64% [10].…”

“…Although physical examination is most commonly used to detect the presence of a clinical varicocele [1, 13], methods using radiologically documented recurrence after varicocele repair are still controversial [14]. Some authors have reported that selective internal spermatic venography (SISV) is helpful to document varicocele recurrence [8, 9, 14, 15]. …”