Related Experiment Videos
[Echo-flowmetric control 6 years after percutaneous treatment of varicocele]
C Trombetta1, E Salisci, M Deriu
1Istituto di Clinica Urologica, Università degli Studi, Sassari.
Insights
Percutaneous sclerotherapy for left varicocele demonstrates long-term efficacy. This minimally invasive treatment, performed on an outpatient basis, proved effective in 87.5% of patients after six years, confirming its lasting results.
Area of Science:
- Interventional Radiology
- Urology
Background:
- Long-term efficacy of sclerotherapy for varicocele remains debated.
- Percutaneous treatments are often questioned regarding lasting occlusion.
- Understanding venous collaterals is crucial for effective radiological treatment planning.
Purpose of the Study:
- To evaluate the long-term efficacy of percutaneous sclerotherapy for left varicocele.
- To assess the durability of spermatic vein occlusion achieved with sclerosing agents.
Main Methods:
- Retrospective follow-up of 27 patients treated with percutaneous sclerotherapy since 1986.
- 16 patients underwent repeat physical examination, Doppler flowmetry, and scrotal ultrasound after six years.
- Sclerosing agents used included sodium tetradecyl sulphate and alcohol.
Main Results:
- Varicocele recurrence was confirmed in only 2 out of 16 patients (12.5%) after six years.
- This indicates a long-term efficacy rate of 87.5% for the percutaneous sclerotherapy procedure.
- The study confirms the lasting occlusion achieved with the adopted sclerotherapy techniques.
Conclusions:
- Percutaneous sclerotherapy for left varicocele, when performed using specific established procedures, offers durable long-term efficacy.
- The treatment is effective in achieving lasting occlusion of spermatic veins, with a low recurrence rate.
- This minimally invasive, outpatient procedure is a viable option for managing left varicocele.
Abstract:
Several Authors have discussed the long term efficacy of sclerotherapy; somebody supposes that percutaneous angiographic treatment of spermatic vein is not sure at all because the occlusion due to the sclerosing agents is not retained as long lasting. Studies have been done by other Authors about comparison of recurrent varicocele anatomy following surgery and percutaneous balloon occlusion: it is concluded that venous collaterals are identified easily by renal venography, and knowledge of these collaterals is helpful in planning further radiological treatment. Since 1980 we have always treated left varicocele by means of percutaneous sclerotherapy of the spermatic veins following renal phlebography: the treatment is done on an outpatient basis, in local anaesthesia. Sclerosing agents we usually adopt are: sodium-tetradecyl sulphate and alcohol. At our knowledge long-term results of this treatment have never been published; this is the reason for which long-term follow-up of 27 patients that 6 years ago underwent percutaneous sclerotherapy was done. Only 16 of them have accepted to repeat: a) physical examination; b) Doppler flowmetry; c) scrotal ultrasound. The presence of a varicocele was demonstrated in 2 out of 16 patients (12.5% of the case). These data confirms that percutaneous treatment performed following the procedures we adopted in 1986 has a long term efficacy in 87.5% of the cases.(ABSTRACT TRUNCATED AT 250 WORDS)