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Updated: Nov 7, 2025

Combination of High Ligation and Intraoperative Embolization using Polidocanol for Treatment of Varicoceles
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Liquid and Solid Embolic Agents in Gonadal Veins.

Francesco Tiralongo1, Giulio Distefano1, Monica Palermo1

  • 1Radiology Unit I, Department of Medical Surgical Sciences and Advanced Technologies "GF Ingrassia"-University Hospital "Policlinico-San Marco", University of Catania, Via Santa Sofia n° 78, 95123 Catania, Italy.

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|April 30, 2021
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Summary
This summary is machine-generated.

Endovascular embolization offers effective treatment for male varicocele and pelvic congestion syndrome (PCS), improving quality of life and fertility. This review details techniques and agents, showing high success rates and rare complications for these common male and female vascular conditions.

Keywords:
embolic agentinterventional radiologypelvic congestion syndromevaricocelevein embolization

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Area of Science:

  • Interventional Radiology
  • Vascular Surgery
  • Urology

Background:

  • Male varicocele and pelvic congestion syndrome (PCS) are prevalent conditions in young individuals, significantly impacting fertility and quality of life.
  • Endovascular embolization is an emerging treatment modality with promising clinical outcomes for both pathologies.

Purpose of the Study:

  • To present the current state-of-the-art in endovascular embolization techniques for male varicocele and PCS.
  • To evaluate the performance of various embolic agents used in these treatments.
  • To provide an updated clinical guide for interventional radiologists and clinicians.

Main Methods:

  • An extensive literature analysis of original studies and previous meta-analyses was conducted.
  • The review focused on technical aspects, clinical outcomes, and the efficacy of different embolic agents.
  • Data on success rates, recurrence, and complication profiles were synthesized.

Main Results:

  • Endovascular treatment for male varicocele shows success rates between 70% and 100%, with recurrence up to 16%.
  • Pelvic congestion syndrome (PCS) treatment achieves high technical success, though recurrence rates vary significantly.
  • Complications are infrequent, primarily including pain, embolic material migration, and vascular perforations; severe adverse events are rare.

Conclusions:

  • Endovascular embolization is a safe and effective treatment for male varicocele and PCS.
  • The review provides valuable insights into technique selection and embolic agent choice for clinicians.
  • Further research may refine recurrence rates and long-term outcomes for PCS embolization.