Transcatheter foam sclerotherapy of symptomatic female varicocele with sodium-tetradecyl-sulfate foam.
To evaluate the efficacy of transcatheter foam sclerotherapy (TCFS) in pelvic varicocele using sodium-tetradecyl-sulfate foam (STSF), we conducted a retrospective study in 38 patients (mean age, 36.9 years; range, 22-44 years) with pelvic congestion syndrome (PCS) treated between January 2000 and June 2005 by TCFS. Pelvic pain was associated with dyspareunia in 23 (60.5%) patients, urinary urgency in 9 (23.7%) patients, and worsening of pain during menstruation and at the end of a day of work in 7 (18.4%) and 38 (100%) patients, respectively. Diagnosis was made by pelvic and transvaginal color Doppler ultrasound examination, demonstrating ovarian or pelvic varices with a diameter >5 mm presenting venous reflux. TCFS was performed in all patients, using 3% STSF. Follow-up was performed by physical examination, pelvic and transvaginal Doppler ultrasound examination and by a questionnaire-based assessment of pain at 1, 3, 6, and 12 months after the procedure. Technical success was achieved in all patients (100%). In three patients a pelvic colic-like pain occurred immediately after sclerotic agent injection, disappearing spontaneously after a few minutes. No recurrent varicoceles were observed during a 12-month follow-up. A statistically significant improvement in each category of specific symptoms was observed at 1, 3, 6, and 12 months after the procedure. We conclude that TCFS of female varicocele using a 3% STSF is safe and effective for the treatment of PCS. It is associated with a significant reduction of symptoms and can be regarded as a valid alternative to other endovascular and surgical techniques.
Gandini
Roberto
R
Department of Diagnostic and Molecular Imaging, Interventional Radiology, Nuclear Medicine and Radiation Therapy, University of Rome "Tor Vergata,", 81 Oxford Street, 00133, Rome, Italy.
Chiocchi
Marcello
M
Konda
Daniel
D
Pampana
Enrico
E
Fabiano
Sebastiano
S
Simonetti
Giovanni
G
D000328:Adult; D002404:Catheterization / Q000379:methods; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010053:Ovary / Q000098:blood supply*; D010147:Pain Measurement; D017060:Patient Satisfaction; D010388:Pelvis / Q000098:blood supply* / Q000503:physiopathology; D010690:Phlebography / Q000379:methods; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012597:Sclerosing Solutions / Q000008:administration & dosage; D015911:Sclerotherapy / Q000379:methods*; D012720:Severity of Illness Index; D012981:Sodium Tetradecyl Sulfate / Q000627:therapeutic use*; D016896:Treatment Outcome; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000628:therapy*
D012597:Sclerosing Solutions; D012981:Sodium Tetradecyl Sulfate