Sklerotherapie der Vena spermatica interna bei Varikozele

Abstract

During a period of four years, 386 patients with left sided varicoceles were treated by sclerotherapy of the left internal spermatic vein. This was successful in 93.8%. The most common complication was perforation of the vein in 6.2%. Technical success and complications depended on anatomical variations. Of particular significance was Bähren type IVb (competent main vein, incompetent collaterals) which occurred in 18.9%. This accounted for 66.5% of all perforations and 54.2% of unsuccessful interventions. The recurrence rate was 3.8%.

Anastomoses between the spermatic and visceral veins:a retrospective study of 500 consecutive patients

“…Visceral-spermatic vein shunts were subsequently demonstrated prospectively during spermatic venography. These anastomoses have not been discussed by other investigators [20,21], and we suggest that our low recurrence rate of 1.2% is due to careful identification of all communications, including visceral-spermatic venous shunts. Among the reasons for failure reported by Zuckerman et al [20], we did not encounter ''veins too small to embolize'' by sclerotherapy.…”

“…To achieve this, the tip of the guiding catheter was placed in projection over the upper onethird of the sacroiliac joint. However, the spermatic vein must not be sclerosed too close to its origin, Perrier's venous funicular plexus [13], due to the risk of painful testicular inflammation [21]. The pampiniform plexus was also protected by a soft compression of the inguinal canal.…”