Related Experiment Video
Updated: Aug 24, 2026
Grade III Varicocele Surgical Treatment using Spermatic Vein-Superficial Abdominal Vein Shunt
Published on: August 23, 2024
Evolution in varicocele sclerosing treatment: the ante/retrograde (A/R) approach
Sergio Minucci1, Guglielmo Mazzoni, Annalisa Gallina
1Interventional Vascular Radiology, S. Camillo-Forlanini Hospital, Roma, Italy.
Objective:
To evaluate diagnostic and therapeutic efficacy of simultaneous ante/retrograde (A/R), trans-scrotal and trans-brachial approach in sclerotherapy of varicocele.
Materials And Methods:
Between June 2000 and June 2002, 99 patients with varicocele were submitted to simultaneous A/R sclerotherapy of internal spermatic venous plexus. All presented grade III left varicocele, 39 also had right varicocele. Recurrent left varicocele was present in 25 following surgical ligations, in 1 following retrograde sclerosis, in 3 following both surgical and sclerosing techniques. Simultaneous A/R approach was performed using transbrachial percutaneous access for retrograde catheterization which does not obstruct trans-scrotal surgical field. The procedure is performed without need for general anaesthesia.
Results:
Sclerotherapy of spermatic veins was always completed. At minimum 12 months follow-up (mean 18 months), only 1 failure was observed.
Conclusion:
Trans-scrotal access allowed to guide, by means of antegrade venography, retrograde selective cannulation of spermatic vein. A/R procedure allows a complete diagnostic evaluation of collateral circulation, with possibility to occlude all vessels draining varicocele. Results at long-term follow-up show very low incidence of recurrence.
