title: Sclerotherapy of the pampiniform plexus with modified Marmar technique in children and adolescents.
abstract: OBJECTIVE
  Treatment of varicocele in children is a debated problem for which no validated guidelines exist. Several techniques have been proposed to solve this problem. The aim of this study was to evaluate the effectiveness and applicability of a modified Marmar technique in the treatment of varicocele in children and adolescents.
  
  
  METHODS
  From April 2004 to September 2005, we evaluated 25 patients between the ages of 9 and 18 (mean 14.4) years, who suffered from left-sided varicocele with concomitant testicular hypotrophy. The diagnosis was ascertained clinically and with scrotal color Doppler ultrasound using the Dubin and Amelar classification. In 2 cases phimosis was also present. The operation was performed according to a modified Marmar technique, using embolization of the pampiniform plexus with 2 ml of 3% polidocanol. Patients underwent clinical evaluation and scrotal color Doppler ultrasound at 1 week and 3 and 6 months.
  
  
  RESULTS
  The mean duration of the operation was 42 min. At 1 week after surgery no persistence of varicocele was found. In 1 patient, edema of the spermatic cord occurred for about 2 months with spontaneous regression, in 1 patient homolateral hydrocele was observed. At 6 months no other complications were reported. No case of testicular atrophy was observed.
  
  
  CONCLUSIONS
  The technique described has already been validated in the adult population, and although we present only a small number of cases, the operation proved easy to perform, safe, of low cost and can be considered a valid alternative to the microsurgical technique in children and adolescents.
authors.affiliation: Academic Division of Urology, Policlinico San Donato, University of Milan, Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Carmignani
authors.forename: Stefano
authors.initials: S
authors.lastname: Casellato
authors.forename: Giacomo
authors.initials: G
authors.lastname: Galasso
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bozzini
authors.forename: Matteo
authors.initials: M
authors.lastname: Spinelli
authors.forename: Carlo Alberto
authors.initials: CA
authors.lastname: Dell'Agnola
authors.forename: Francesco
authors.initials: F
authors.lastname: Rocco