Transfemoral percutaneous scleroembolysation of spermatic veins: Four years of esperience

G. Favini, L. Cannignani, G. Strada, M. Sala, M. Gadda, F. Rocco, H. S. Gerardo

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PURPOSE :Until now there hasn't been one common method of treating the varicocele.The most common used method depends on what the urologist is accustomed to doing and on collaboration between the surgeon and the intcrventional radiologist. The scleroembolisation is now a standardised method and with an adeguate follow up for a correct valuation of it's efficacy. We want to evaluate the short and long term results and the costs of this method. MATERIALS AND METHODS We proceed the percutaneous sclerosis of the varicocele by a transfemoral catheterization. For the right varicocele an approach through the superior limbs was used (the basiliac vein). After catheterization of the internal spermatic vein a flebography was perfomed for the study of the various veins. At this moment we changed the diagnostic catheter for a bakion catheter positioned distally. The eventual distal reflux of the drugs was impeded by the position of the emostatic band at the level of the scrotum. We inject "Trombovar" at 3% taking care not to exceedThe drag was partially aspirated during the procedure The procedure from start to finish took about 90 minutes. Fluoroscopic time, with an expert operator is very short.The scrotum was covered by device The diagnosis was performed with a clinical and aappler ultrasound above the parnpiniform plexus we used the Dubin and Amilar classiftcation.From 1.92 to 9.% we treated 216 patients with sclerotherapy with a total of 224 treatments In 8 cases we repeated the sclerotherapy after the first treatment failed. In one case it was necessary to repeat the treatment 3 rimes. In 29 cases we treated post-surgical failures, two of these patients had already had 2 failed surgical treatments.ln 9 cases the varicocele was bilateral. RESULTS The follow up after three months showed that we cured the varicocdes in 196 cases. In 20 cases the treatment failed. Of 29 recurrent cases after surgery we cured 24 The main cause of failure was the impossibility to catheterize the spermatic vein. We shall also present the long term results. Complication in one case we couldn't deflate the baloon, in one case there was prolacled bleeding in the catheter zone and in one case the spermatic vein dried up. CONCLUSION Sclerotherapy in the varicocele is a safe method without important complications, and is efficacious in the cure of varicoceles. Exposure to radiation and the relatively long duration of this method seem to be the main disadvantage of this method.

Original languageEnglish
Pages (from-to)340
Number of pages1
JournalBritish Journal of Urology
Issue numberSUPPL. 2
Publication statusPublished - 1997

ASJC Scopus subject areas

  • Urology


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