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Updated: Jun 16, 2026
Combination of High Ligation and Intraoperative Embolization Using Polidocanol for Treatment of Varicoceles
Published on: December 22, 2023
Initial experience with percutaneous selective embolization: A truly minimally invasive treatment of the adolescent
Douglas W Storm1, Mark J Hogan, Venkata R Jayanthi
1Nationwide Children's Hospital, Department of Urology, 700 Children's Drive, G280, Timken Hall, Columbus, OH 43205, USA. Douglas.Storm@nationwidechildrens.org
Objective:
Postoperative hydrocele development is a frustrating complication of varicocele surgical repair. To avoid this complication, we began to offer percutaneous embolization as a treatment option. We present our initial experience with this technique.
Methods:
A retrospective review of all patients who underwent percutaneous embolization and sclerotherapy of a varicocele at our institution was performed.
Results:
There were 27 patients with a mean age of 16 years (range 13-19 years). Indications included pain (48%), varicocele size (30%) and persistent testicular asymmetry (22%). Four patients had experienced failure of a previous surgical repair. Follow-up data were available for 21 patients (mean 9 months). The varicocele resolved in 19 patients (91%) with no evidence of hydrocele formation in any of the boys. There was resolution of pain in all patients for whom this was the indication for the procedure. In the two failures, access to the lower spermatic vein was not possible owing to the number and tortuosity of the vessels.
Conclusions:
Percutaneous embolization and sclerotherapy represent a truly minimally invasive treatment with low morbidity, minimal pain and rapid recovery. In our early experience, since lymphatic channels are completely avoided, there appears to be no risk of hydrocele formation.
