Sclerotherapy of the pampiniform plexus with modified marmar technique in children and adolescents

Luca Carmignani, Stefano Casellato, Giacomo Galasso, Giorgio Bozzini, Matteo Spinelli, Carlo Alberto Dell'Agnola, Francesco Rocco

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Aims: Treatment of varicocele in children is a debated problem for which no validated guidelines exist. Several techniques have been proposed to solve this problem. The aim of this study was to evaluate the effectiveness and applicability of a modified Marmar technique in the treatment of varicocele in children and adolescents. Methods:From April 2004 to September 2005, we evaluated 25 patients between the ages of 9 and 18 (mean 14.4) years, who suffered from left-sided varicocele with concomitant testicular hypotrophy. The diagnosis was ascertained clinically and with scrotal color Doppler ultrasound using the Dubin and Amelar classification. In 2 cases phimosis was also present. The operation was performed according to a modified Marmar technique, using embolization of the pampiniform plexus with 2 ml of 3% polidocanol. Patients underwent clinical evaluation and scrotal color Doppler ultrasound at 1 week and 3 and 6 months. Results: The mean duration of the operation was 42 min. At 1 week after surgery no persistence of varicocele was found. In 1 patient, edema of the spermatic cord occurred for about 2 months with spontaneous regression, in 1 patient homolateral hydrocele was observed. At 6 months no other complications were reported. No case of testicular atrophy was observed. Conclusions: The technique described has already been validated in the adult population, and although we present only a small number of cases, the operation proved easy to perform, safe, of low cost and can be considered a valid alternative to the microsurgical technique in children and adolescents.

Original languageEnglish
Pages (from-to)187-190
Number of pages4
JournalUrologia Internationalis
Issue number2
Publication statusPublished - Mar 2009


  • Marmar technique, modified
  • Pediatrics
  • Sclerotherapy
  • Varicocele

ASJC Scopus subject areas

  • Urology


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