Anastomoses between the spermatic and visceral veins: a retrospective study of 500 consecutive patients.
BACKGROUND
Do visceral-spermatic vein shunts have any clinical impact on sclerotherapy of varicoceles?


METHODS
The spermatic venograms of 500 consecutive patients were retrospectively reviewed to classify visceral-spermatic communications. Men with an average age of 27.8 years (range 11-65 years old) underwent sclerotherapy of a varicocele. Of the 500 men, 445 were referred for oligoasthenospermia (89%), 45 for pain (9%), and 10 for prevention of infertility (2%). After bilateral catheterization, percutaneous sclerosis was performed below the upper third of the sacroiliac joint.


RESULTS
Three hundred forty patients (68%) had left-sided, 10 (2%) had right-sided, and 150 (30%) had bilateral varicoceles. Left side: Of 46 (9.4%) anastomoses, one (0.2%) communicated with the splenic vein and 45 (9.2%) with the inferior mesenteric vein of which 25 (5.1%) were a colic trunk with a competent valve, 15 (3.1%) were venules, and five (1%) were a single or double anastomosis. Right side: Of 48 (29.6%) anastomoses to the superior mesenteric vein, 34 (21%) were venules, 12 (7.4%) were a colic trunk with a competent valve, and two (1.2%) were a single or double vein. Our varicocele recurrence rate was only 1.2%.


CONCLUSIONS
Visceral-spermatic vein communications are classified by number, morphology, and site. Percutaneous sclerotherapy could be optimized when performed caudally to these communications.
Bigot
J M
JM
Department of Radiology, Hôpital Tenon, 4, rue de la Chine, F-75970 Paris Cedex 20, France.
Le Blanche
A F
AF
Carette
M F
MF
Gagey
N
N
Bazot
M
M
Boudghene
F P
FP
D000293:Adolescent; D000328:Adult; D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D015911:Sclerotherapy; D013737:Testis / Q000098:blood supply*; D016896:Treatment Outcome; D014646:Varicocele / Q000000981:diagnostic imaging / Q000628:therapy*; D014781:Viscera / Q000098:blood supply*