Adolescent varicocele: treatment by antegrade sclerotherapy.
OBJECTIVE
The most effective treatment for adolescent varicocele is still debated, although the same treatment methods used for adults have also been used in children. Since 1991 at the Pediatric Surgery Operative Unit of "S. Camillo" Hospital in Rome a multidisciplinary protocol has been established according to which percutaneous retrograde scleroembolization was suggested as the first therapeutic option. Surgery (retroperitoneal ligation) was reserved for select cases. The author now presents his personal experience with alternative-approach antegrade sclerotherapy.


METHODS
Since February 1998, as an alternative to percutaneous retrograde sclerosis and surgical ligation, antegrade sclerotherapy has been performed in 92 varicocele patients, 65 of whom were 11 to 19 years of age. In this group, the indication for treatment was grade III varicocele with spontaneous continual reflux, which worsened with the Valsalva maneuver. Twenty patients had recurrent varicocele after other treatments.


RESULTS
At a mean follow-up of 9 months, the clinical recovery rate was 92.6%.


CONCLUSIONS
Antegrade sclerotherapy is an intermediate treatment because of its invasive nature and success rate compared with more commonly used percutaneous retrograde sclerosis and Palomo procedures in adolescents. In particular, this method is highly effective and well-accepted by patients with recurrent varicocele.
Mazzoni
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Pediatric Surgery Operative Unit, "S. Camillo" Hospital, "S. Camillo-Forlanini" Hospital Institution, Rome, Italy.
D000293:Adolescent; D000328:Adult; D002648:Child; D006801:Humans; D008297:Male; D011859:Radiography; D012008:Recurrence; D015911:Sclerotherapy; D014646:Varicocele / Q000000981:diagnostic imaging / Q000628:therapy*