Anatomic variants of the spermatic vein: importance for percutaneous sclerotherapy of idiopathic varicocele.
OBJECTIVE
To evaluate percutaneous sclerotherapy of idiopathic varicocele in left internal spermatic vein variants.


METHODS
The left spermatic vein was embolized with a liquid sclerosing agent in 386 patients (mean age, 29.5 years) with idiopathic varicocele. Success and complication rates were assessed and correlated with spermatic vein variant. Doppler ultrasound was performed 3 and 6 months after therapy in 263 patients.


RESULTS
The success rate was 93.8% (n = 362). Perforation of the vein was the most common complication (n = 24). The recurrence rate was 3.8% (10 of 263 patients). Success and complication rates were associated with spermatic vein variant. Type IVb (intact valve of the main trunk, insufficient collateral vessels; n = 73) was of special importance: 67% (16 of 24) of all perforations occurred and 54% (13 of 24) of all unsuccessful interventional procedures were performed in patients with this variant.


CONCLUSIONS
Sclerotherapy is a safe and effective alternative treatment of idiopathic varicocele. It can be performed on an outpatient basis. Success depends on the anatomic variant.
Lenz
M
M
Department of Diagnostic Radiology, Technical University of Munich, Germany.
Hof
N
N
Kersting-Sommerhoff
B
B
Bautz
W
W
D000328:Adult; D016022:Case-Control Studies; D006801:Humans; D007248:Infertility, Male / Q000209:etiology; D008297:Male; D011859:Radiography; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D015911:Sclerotherapy / Q000379:methods*; D013085:Spermatic Cord / Q000098:blood supply*; D017211:Treatment Failure; D014646:Varicocele / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D014680:Veins / Q000033:anatomy & histology
D012597:Sclerosing Solutions