Percutaneous transluminal treatment of varicoceles: where to occlude the internal spermatic vein

Percutaneous transluminal sclerotherapy is an accepted treatment for varicoceles. It is administered by applying a liquid sclerosing agent to the internal spermatic vein. However, the optimal site for the placement of the occlusive material has not been evaluated previously. Therefore, the success rate of sclerotherapy was determined in two groups of patients. In the first group (34 patients), the liquid agent was applied in the cranial part of the internal spermatic vein; in the second group (113 patients), the agent was applied in the caudal part of the vessel at the level of the inguinal ring. The success rate determined 3 months after therapy by telethermography was significantly higher after treatment in the caudal part (82%) than in the cranial part (68%) of the vessel. Sclerotherapy at the level of the inguinal ring appears to be superior to therapy in the cranial part of the internal spermatic vein.