Percutaneous embolization of varicocele in children: A Canadian experience

The importance of early treatment of varicocele, to prevent testicular damage is widely accepted. Surgical treatment of varicocele has been the standard method of therapy, but recently a less invasive procedure was introduced and utilized mostly in Europe. The authors reviewed their experience with percutaneous embolization and sclerotherapy to assess the feasibility and outcome of this approach in children.

The authors conducted a retrospective study including all patients who underwent percutaneous embolization and sclerotherapy for varicocele in the authors' institutions for the last 10 years. Clinical data, investigation, pre and postintervention management, and the technique of the procedure, including sedation and anesthesia when needed, were collected from the charts. Follow-up was obtained from the chart or by phone.

Between 1991 and 2001, 41 patients underwent 43 percutaneous interventions. The median age was 14 years (range, 10 to 20 years). All but 2 were injected with a sclerosing agent; in 26 cases coils were added. All procedures except one were done under local anesthesia with sedation. Only 2 patients were admitted overnight, and 5 patients had minor complications. The average procedure time was 55 minutes. Follow-up data were obtained in 39 patients (95%), with a mean follow-up of 22 months. A total of 89.1% of those who were injected have satisfactory results (cured or improved) without the need for further procedures. Six patients required surgery post-percutaneous procedure, 4 because of persistent or recurrent varicocele and 2 because of technical failure.

Percutaneous embolization is a safe and effective treatment of varicocele in children with technical success in 95% and therapeutic success in 89%. It now is the authors' first treatment modality for this disease.