title: Suprapubic percutaneous sclero-embolization of symptomatic female pelvic varicocele under local anesthesia.
abstract: OBJECTIVE
  To evaluate the safety and feasibility of supra-pubic percutaneous sclero-embolization (SE) in the treatment of symptomatic female pelvic varicocele (FPV), performed under local anesthesia.
  
  
  METHODS
  The authors selected 28 patients screened by transabdominal and transvaginal ultrasound, with venous Doppler signal. Clinicians performed SE by transfemoral catheterization, under local anesthesia, using of a mix of 2 ml of lauromacrogol 400 (Atossisclerol 3%, Chemische F. Kreussler, Wiesbaden, Germany) and 2 ml of air, in a mixed foam fashion.
  
  
  RESULTS
  The total operative time for SE was 7.6 +/- 2.1 min. Intra-surgical blood loss was 40 +/- 14 ml. No migration of sclerosant material occurred and postoperative analgesic request during a 48 hr period occurred in 6 patients. Technical success was 100%. The Authors embolized 8 women bilaterally (28.5%), 18 on the left ovarian vein (OV) (64.2%) and 2 only in the right OV (7.1%): 7 women complained of transitory flank pain (25%), which disappeared in few minutes. The major complications in 10 days after SE were: fever (> 38 degrees C for two days) in 2 patients (7.1%) and pelvic pain for 3 days in eight patients (28.5%). After 30 days only 6 women suffered of FPV lower symptoms which disappeared in 180 days. A substantial reduction in size of pelvic varicosities was noted in all patients.
  
  
  CONCLUSIONS
  SE is a safe and feasible procedure. It reduces significantly the mean time of scopies, the intensity of radiation emission, and it is performed under local anaesthesia. This minimally invasive procedure could be proposed to all women with supra-pubic FPV for its reproducibility and feasibility.
authors.affiliation: Department of Obstetrics and Gynaecology, Vito Fazzi Hospital, Lecce, Italy. andreatinelli@gmail.com
authors.forename: A
authors.initials: A
authors.lastname: Tinelli
authors.forename: R
authors.initials: R
authors.lastname: Prudenzano
authors.forename: M
authors.initials: M
authors.lastname: Torsello
authors.forename: A
authors.initials: A
authors.lastname: Malvasi
authors.forename: G
authors.initials: G
authors.lastname: De Nunzio
authors.forename: I
authors.initials: I
authors.lastname: De Mitri
authors.forename: M
authors.initials: M
authors.lastname: Bochicchio
authors.forename: D A
authors.initials: DA
authors.lastname: Tsin
authors.forename: P
authors.initials: P
authors.lastname: Krishnan
authors.forename: J M
authors.initials: JM
authors.lastname: Wiley
mesh_terms: D000328:Adult; D000772:Anesthesia, Local; D004621:Embolization, Therapeutic; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy; D010388:Pelvis / Q000098:blood supply; D012039:Regional Blood Flow; D012597:Sclerosing Solutions / Q000627:therapeutic use; D012725:Sexual Behavior; D025321:Surgery, Computer-Assisted; D016896:Treatment Outcome; D014463:Ultrasonography; D014646:Varicocele / Q000000981:diagnostic imaging / Q000628:therapy*
chemical_list: D012597:Sclerosing Solutions