title: Tolerance of glue embolization under local anesthesia in varicoceles: a comparative study of two different cyanoacrylates.
abstract: OBJECTIVE
  To find out whether in varicocele embolization the copolymer cyanoacrylate glue (NBCA-MS) has a better patient tolerance compared to the monomer n-butyl-2-cyanoacrylate (NBCA).
  
  
  METHODS
  N=112 insufficient spermatic veins (left sided N=84, right sided N=28) diagnosed in N=83 adult males were prospectively randomized for blinded embolization with either NBCA N=54 (Histoacryl) or with NBCA-MS N=58 (Glubran2). Before, during and up to one week after embolization, patient discomfort was assessed by a standardized pain scale. Type, location and side of discomfort were noted. Statistical analysis was performed with the Mann-Whitney U-test, the McNemar test and the Fisher's exact test.
  
  
  RESULTS
  Embolization caused discomfort in N=48/112 (43%) spermatic veins, comprising N=26/54 (48%) in the NBCA group and N=22/58 (38%) in the NBCA-MS group. During the week after embolization, the overall number of discomfort reports rose to N=62/106 (59%), with an increase to N=30/53 (57%) in the NBCA group and to N=32/53 (60%) in the NBCA-MS group. The number of immediate grade 2 to 4 pain reactions was N=22/112 (20%), and rose to N=37/106 (35%) after one week. No difference in discomfort during embolization and at 1 week after treatment was noted. Characteristics, severity grading, and location of discomfort were similar in both NBCA groups, regardless the time point of observation.
  
  
  CONCLUSIONS
  Discomfort after glue embolization of varicocele is a common side effect, which might evolve to pain. The assumed lower inflammatory reaction on NBCA-MS was not translated in an improved tolerance.
authors.affiliation: Department of Vascular and Interventional Radiology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium. Electronic address: peter.vanlangenhove@uzgent.be.
authors.forename: Peter
authors.initials: P
authors.lastname: Vanlangenhove
authors.affiliation: Department of Urology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.
authors.forename: Karel
authors.initials: K
authors.lastname: Everaert
authors.affiliation: Department of Statistics, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.
authors.forename: Georges
authors.initials: G
authors.lastname: Van Maele
authors.affiliation: Department of Vascular and Interventional Radiology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.
authors.forename: Luc
authors.initials: L
authors.lastname: Defreyne
mesh_terms: D000328:Adult; D000779:Anesthetics, Local / Q000627:therapeutic use; D004311:Double-Blind Method; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D004659:Enbucrilate / Q000009:adverse effects* / Q000145:classification / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D010147:Pain Measurement / Q000187:drug effects; D014014:Tissue Adhesives / Q000009:adverse effects* / Q000627:therapeutic use*; D016896:Treatment Outcome; D014646:Varicocele / Q000175:diagnosis / Q000628:therapy*; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D014014:Tissue Adhesives; D004659:Enbucrilate
keywords: Embolization; Varicocele; n-Butylcyanoacrylate