title: Treatment of symptomatic high-flow female varicoceles with stop-flow foam sclerotherapy.
abstract: OBJECTIVE
  To assess the efficacy of stop-flow foam sclerotherapy (SFFS) in high-flow pelvic varicoceles using 3 % sodium tetradecyl sulfate (STS) foam.
  
  
  METHODS
  Our institutional review board granted approval and waived informed consent for this retrospective study of 26 patients (mean age 37.3 years, range 23-46 years) with pelvic congestion syndrome (PCS) who had high-outflow venous collaterals treated by SFFS between June 2005 and June 2011 in our department. PCS was diagnosed by physical and transvaginal color Doppler ultrasound examination, while high-outflow venous collaterals were detected at selective ovarian venography. SFFS was performed by injection of 3 % STS foam into the pelvic varices after balloon occlusion of the major venous vessels (hypogastric and/or ovarian veins) to which the high-outflow venous collaterals were tributary. Follow-up was performed at 1, 3, 6, and 12 months by physical and transvaginal color Doppler ultrasound examination and by a questionnaire-based assessment of pain using a symptom severity score.
  
  
  RESULTS
  The procedure was technically successful in all patients. After the injection of 3 % STS foam, all patients had a colic like pain that spontaneously resolved after 5 min. During follow-up, no recurrences of PCS were detected. Significant improvement of symptoms (Student's t test P < 0.01) was observed at 1, 3, 6, and 12 months.
  
  
  CONCLUSIONS
  SFFS using 3 % STS foam is a safe and effective treatment for high-flow female varicoceles and should be considered as an alternative to other endovascular and surgical options.
authors.affiliation: Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, Fondazione Policlinico di Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Gandini
authors.forename: Daniel
authors.initials: D
authors.lastname: Konda
authors.forename: Sergio
authors.initials: S
authors.lastname: Abrignani
authors.forename: Marcello
authors.initials: M
authors.lastname: Chiocchi
authors.forename: Valerio
authors.initials: V
authors.lastname: Da Ros
authors.forename: Daniele
authors.initials: D
authors.lastname: Morosetti
authors.forename: Giovanni
authors.initials: G
authors.lastname: Simonetti
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010053:Ovary / Q000098:blood supply*; D017699:Pelvic Pain / Q000209:etiology / Q000628:therapy; D010388:Pelvis / Q000098:blood supply*; D010690:Phlebography / Q000379:methods; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000627:therapeutic use; D015911:Sclerotherapy / Q000379:methods*; D012981:Sodium Tetradecyl Sulfate / Q000627:therapeutic use; D013577:Syndrome; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D014648:Varicose Veins / Q000150:complications / Q000628:therapy*
chemical_list: D012597:Sclerosing Solutions; D012981:Sodium Tetradecyl Sulfate