Antegrade scrotal sclerotherapy in the treatment of varicocele: a prospective study.
OBJECTIVE
To assess the results of our experience in correcting primary varicocele using a modified technique of antegrade scrotal sclerotherapy.


METHODS
From December 1997 to February 2000, 201 patients with primary varicocele underwent antegrade scrotal sclerotherapy. Before treatment all patients were evaluated by a physical examination, colour Doppler ultrasonography of the spermatic cord, and abdominal and scrotal ultrasonography. Sperm samples were analysed only in patients aged > 18 years. The treatment was administered using a special venous catheter system with a Y-adapter. Complications after treatment and the rate of persistence of reflux were assessed 3 and 6 months after the antegrade scrotal treatment, by clinical examination and colour-Doppler ultrasonography of the spermatic cord.


RESULTS
The mean operative duration was 15 min; there were no significant complications during treatment and all patients were discharged within 4 h. Complications after treatment occurred in 10 of the 201 patients (5%); four patients had epididymo-orchitis, three a scrotal haematoma, one a surgical wound infection, one persistent scrotal pain and one persistent flank pain on the same side as the surgery. Reflux was persistent in 12 patients (6%).


CONCLUSIONS
Antegrade scrotal sclerotherapy is a simple, minimally invasive and highly effective technique for blocking spermatic vein reflux, with a low rate of complications. The technical changes simplified the cannulation of the spermatic vein and facilitated antegrade phlebography and sclerotherapy using the air-block technique.
Ficarra
V
V
Department of Urology, University of Verona, Italy. vincenzoficarra@hotmail.com
Porcaro
A B
AB
Righetti
R
R
Cerruto
M A
MA
Pilloni
S
S
Cavalleri
S
S
Malossini
G
G
Artibani
W
W
D000293:Adolescent; D000328:Adult; D002406:Catheterization, Peripheral; D002648:Child; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011446:Prospective Studies; D012597:Sclerosing Solutions / Q000008:administration & dosage*; D015911:Sclerotherapy / Q000379:methods*; D013076:Sperm Count; D013081:Sperm Motility; D016896:Treatment Outcome; D014646:Varicocele / Q000503:physiopathology / Q000628:therapy*
D012597:Sclerosing Solutions; D000077423:Polidocanol; D011092:Polyethylene Glycols