polidocanol and Varicocele

We delineate the role of phlebography which is a standard procedure during antegrade and retrograde sclerotherapy of idiopathic varicoceles.. Based on our experience with antegrade sclerotherapy in 5,254 adults and adolescents we present typical phlebographies of the internal spermatic vein and radiological images after irregular cannulation of different arteries and veins on the scrotal floor. The sequalae of misinjections and paravascular application of the sclerosing agent polidocanol are discussed. A radiological classification of venous drainage roots of the pampiniform plexus is introduced on the basis of 236 consecutive antegrade phlebographies. The findings are compared with the results of retrograde phlebography previously given in literature.. Phlebography helps to ascertain that sclerotherapy is performed in an anatomically appropriate manner. Thus, misinjections and paravascular applications of polidocanol can be ruled out. Antegrade phlebography enables to visualize a high rate of side veins and collaterals of the internal spermatic vein and thus seems to be equivalent to the retrograde imaging in tracing the additional drainage roots of the pampiniform plexus. These additional roots are considered to be the source of persisting varicoceles after surgical treatment.. Phlebography is needed to achieve good results after sclerotherapy of varicoceles and to minimize the toxic side effects of polidocanol. Finally it is a prove that the treatment has been performed accurately for forensic reasons.

Topics: Abdominal Wall; Catheterization; Clinical Protocols; Humans; Male; Malpractice; Necrosis; Phlebography; Polidocanol; Polyethylene Glycols; Sclerosing Solutions; Sclerotherapy; Spermatic Cord; Varicocele; Veins

Topics: Adrenal Glands; Adult; Humans; Male; Phlebography; Polidocanol; Polyethylene Glycols; Sclerosing Solutions; Spermatic Cord; Testis; Varicocele; Veins

The usefulness of treating varicocele in order to improve fertility is still a matter of debate. The aim of this study was to evaluate variations in seminal parameters and inhibin B concentrations in a group of males affected by varicocele and treated by percutaneous retrograde sclerotherapy in comparison with a group of patients who did not undergo varicocele treatment. Thirty-eight patients with left varicocele underwent spermatic vein phlebography and percutaneous retrograde sclerotherapy with hydroxy-polyaethoxy-dodecanol. Serum inhibin B, follicle-stimulating hormone (FSH), testosterone levels and seminal parameters (sperm concentration, motility and morphology) were performed before and 6 months after sclerotherapy. Forty patients with left varicocele who did not undergo sclerotherapy were studied as controls. A significant increase (p < 0.01) in serum inhibin B levels and a significant decrease (p < 0.05) in FSH levels were observed 6 months after treatment. Semen analysis showed a significant improvement in sperm concentration (p < 0.05) and progressive motility (p < 0.01) after treatment. In control group no significant variations in hormonal and seminal parameters were observed 6 months after the basal examination. Six months after the basal evaluation, inhibin B levels were significantly higher in treated subjects than in controls (p < 0.05) whereas FSH levels were significantly lower (p < 0.05). Sperm concentration and progressive motility were significantly increased (p < 0.05 and p < 0.001, respectively) in treated subjects in comparison with controls. In conclusion, varicocele sclerotherapy improves inhibin B levels and seminal parameters, confirming the positive effect of this treatment on spermatogenesis and Sertoli cell function.

Topics: Adolescent; Adult; Case-Control Studies; Follicle Stimulating Hormone; Humans; Inhibins; Male; Phlebography; Polidocanol; Polyethylene Glycols; Sclerosing Solutions; Sclerotherapy; Sperm Count; Sperm Motility; Spermatogenesis; Spermatozoa; Testosterone; Time Factors; Treatment Outcome; Ultrasonography, Doppler, Duplex; Varicocele

Varicocele is a more common male genitourinary system disease with sperm quality dysfunction or discomfort. This study was aimed to compare the clinical efficacy of sclerosing embolization with 3% polidocanol and the microsurgical subinguinal varicocelectomy in treating primary varicocele. Total of 59 patients with primary varicocele receiving a 3-month postoperative follow-up were included to analyse their biochemical parameters and clinical outcomes, including the operative time, hospitalization time, postoperative recurrence rates, and complication rate. Nineteen patients were treated with sclerosing embolization with 3% polidocanol (SE group), while 40 patients were treated with microsurgical subinguinal varicocelectomy (MSV group). For the SE group, 17 patients were treated on the left side, and two patients have treated on both without recurrences and complications during the follow-up period. For the MSV group, three patients were treated bilaterally, and 36 patients were treated separately on the left side with a total 5% recurrence rate and 10% complication rate. The duration of surgery and the hospitalization time of the SE group (46.2 ± 9.79 min and 2.53 ± 0.90 days, respectively) are significantly lower than MSV group (100.5 ± 13.76 min and 3.6 ± 1.58 days, respectively), p < 0.05. The total sperm count at 3 months was significantly higher in the SE group than in the MSV group (p < 0.05). In summary, sclerosing embolization is more effective for varicocele in improving sperm quality, shortening recovery time, and reducing recurrence rates and complications.

Topics: Humans; Male; Microsurgery; Polidocanol; Semen; Treatment Outcome; Varicocele

We report our experience with polidocanol foam sclerotherapy with no additional coils, evaluating clinical success, patients' satisfaction, and complications.. We conducted a retrospective study of 141 patients with 146 varicoceles (mean age: 29.3 years; range: 13 - 60 years) who underwent foam sclerotherapy with polidocanol 2% (range: 2 - 12 ml) in an outpatient setting between January 2007 and December 2013. For the follow-up, telephone interviews with the patients were conducted (mean follow-up time: 46.4 months, standard deviation: 20.17 months).. The technical success rate was 91.8%. There was a 55.8% response rate to the telephone interviews. Follow-up revealed a clinical success rate of 83.9% and a persistence or relapse rate of 16.1%. Of the patients, 81.9% were absolutely satisfied with the outcome. In 94.9% of cases, pain or discomfort resolution was reported, and in 97% of cases, aesthetic issues were no longer a problem. Of partners, 63.2% achieved pregnancy, and in 50% of patients with preprocedural testicular atrophy, catch-up growth was observed. One patient with pampiniform plexus phlebitis received inpatient treatment with no long-term damage recorded.. Polidocanol foam varicocele sclerotherapy is a safe and effective procedure, with a high rate of patients' satisfaction, clinical and technical success, and considerable catch-up growth and pregnancy achievement.. • Varicocele treatment using polidocanol foam sclerotherapy is a safe and effective procedure. • It is easily feasible in an outpatient setting. • The clinical and technical success rates are high. • It shows a high rate of patients' satisfaction and symptom resolution. • Postinterventional catch-up growth and pregnancy achievement are considerable.

Topics: Adolescent; Adult; Atrophy; Catheterization; Feasibility Studies; Humans; Male; Middle Aged; Patient Satisfaction; Polidocanol; Polyethylene Glycols; Recurrence; Retrospective Studies; Sclerosing Solutions; Sclerotherapy; Testis; Treatment Outcome; Varicocele; Young Adult

Varicocele is treated by different surgical techniques, none of which is yet acknowledged as the "gold standard." Some of these techniques, especially microsurgical techniques, are very time consuming and thus expensive, and the treatment of varicocele still causes some complications and recurrences. Marmar and Kim's technique presents some indisputable advantages: it allows the preservation of the arteries and seems to offer the highest percentage of success and lowest number of complications. The authors modified and simplified the microsurgical technique of Marmar and Kim, using a subinguinal approach with intraoperative antegrade sclerotherapy of dilated veins. After the cord has been clamped, 1.5 to 3 mL of 3% aetoxisclerol mixed with 0.5 mL of air is injected. Commonly, minor complications can occur. The most common complication is transient penile lymphangitis, the cause of which is unclear. As the procedure allows selective sparing of the lymphatic vessels, it avoids hydrocele due to the performed procedure.

Topics: Adolescent; Adult; Humans; Inguinal Canal; Male; Microsurgery; Middle Aged; Polidocanol; Polyethylene Glycols; Sclerosing Solutions; Sclerosis; Scrotum; Spermatic Cord; Ultrasonography; Urologic Surgical Procedures, Male; Varicocele

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.. 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.. 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.. 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.

Topics: Adolescent; Child; Combined Modality Therapy; Humans; Male; Polidocanol; Polyethylene Glycols; Recurrence; Reoperation; Sclerosing Solutions; Sclerotherapy; Severity of Illness Index; Time Factors; Treatment Outcome; Ultrasonography, Doppler, Color; Urologic Surgical Procedures, Male; Varicocele

To identify predictors of future pregnancy in partners of infertile men undergoing embolization of varicoceles.. This study was conducted within local institutional review board guidelines, and written informed consent was obtained. In 223 clinically infertile men (age range, 18-50 years) with varicoceles and associated oligoteratoasthenospermia, endovascular embolization of the spermatic veins was performed with distal coil embolization and sclerotherapy. Additional anti-inflammatory treatment was initiated if required. Baseline clinical examination, semen specimen, and hormone level findings were compared to follow-up data. Posttreatment pregnancy rate of their healthy female partners was assessed with a standardized questionnaire. Unconditioned logistic regression was used to identify factors among all available clinical and laboratory data predicting treatment success (sired pregnancy during follow-up).. A total of 226 of 228 varicoceles in 223 patients were successfully treated. Resolution of varicoceles at clinical examination and ultrasonography (US) was observed in 206 patients (92.4%). Three-month follow-up semen analysis in these patients showed significant improvement in sperm motility (P < .001) and sperm count (P < .001); however, average values remained in the abnormal range (World Health Organization guidelines). In 173 patients, follow-up data were successfully obtained, with pregnancy reported in 45 (26%). Baseline sperm motility was identified as the only significant pretreatment factor (standardized regression coefficient beta = 3.285, t = 7.560, P = .006) predicting sired pregnancy. Hormone levels, clinical grading of varicoceles, Doppler US findings, and other semen parameters did not reach statistical significance.. Sperm motility prior to varicocele treatment in infertile men is an important predictor of later pregnancy.

Topics: Adolescent; Adult; Contrast Media; Embolization, Therapeutic; Female; Humans; Infertility, Male; Logistic Models; Male; Middle Aged; Phlebography; Polidocanol; Polyethylene Glycols; Predictive Value of Tests; Pregnancy; Radiography, Interventional; Sclerosing Solutions; Sperm Count; Sperm Motility; Statistics, Nonparametric; Varicocele

The purpose of this study was to present our experience with percutaneous treatment of male varicocele considering technical, clinical, seminal and dosimetric aspects.. At baseline and at 6 months' follow-up, 290 male patients aged between 18 and 37 (average age 27.3 years) with left (266 cases) or bilateral (24 cases) varicocele underwent clinical assessment, Doppler ultrasonography (US), laboratory testing of free and total serum testosterone, leutenising hormone (LH) and follicle stimulating hormone (FSH) gonadotropins, inhibin B and spermiogram. In 223 cases, selective catheterisation of the spermatic vein was performed with a right transfemoral approach. Two hundred and six out of 223 underwent radiological treatment of varicocele; in 194, hydroxy-poliethoxydocanol (Aetoxysclerol) was used only whereas in 12 cases (5.8%), 5 ml of absolute alcohol and a Gianturco coil (0.038-in. Cook coil, 10 mmx50 mm) were also used. In 17/223 patients (7.6%), sclerotherapy was contraindicated or not technically feasible. Sixty-seven patients refused radiological treatment and were used as a control group. In 20 patients, the following parameters were measured: dose area product, entrance surface dose, effective dose and gonad dose.. Technical success was achieved in 206/223 cases; two phlebographic examinations (immediately following administration of the sclerosing agent and after 15-20 min) showed prethrombotic endoluminal alterations of the internal spermatic vein. At 6 months' follow-up, 172/206 patients (83.49%) showed complete resolution of the varicocele whereas 34/206 (16.5%) had only partial disengorgement of the pampiniform plexus. In these 206 patients, the spermogram showed a significant increase in sperm concentration (52.1+/-4.1 vs. 44.2+/-3.6 million/ml, p=0.002) and motility (40.5+/-2.2 vs. 33.3+/-2.0%, p=0.0001), with negligible morphological changes. In the control group and in the other 17 untreated patients, no variations in seminal parameters were observed. The following minor procedural complications were recorded: two cases of acute abdominal pain, three of vagal crisis during administration of sclerosing agent that resolved spontaneously and two of spermatic cord inflammation that resolved within days after medical therapy. We recorded no statistically significant differences with regard to testicular volume or serum hormone levels between the treated and untreated groups. Maximum effective dose and maximum gonad dose equivalent were 6.9 mSv and 0.69 mSv, respectively.. Percutaneous radiological treatment of varicocele is a minimally invasive technique, which is well tolerated by patients and able to significantly improve seminal parameters. The principal technical limitation to percutaneous treatment is related to difficult selective catheterisation of the spermatic vein due to anatomic alterations, spasms and intimal dissection of the vein. Moreover, when the cremasteric vein is incontinent, inguinal surgical ligation provides better results. In the majority of cases, administration of at least 3 ml sclerosing agent at 3% ensures occlusion of the gonadic vein above the abdominal collaterals, which are responsible for long-term recurrence if not treated. In the remaining cases, absolute alcohol and metallic coils can be used to complete the treatment. The positive results in seminal parameters do not, however, allow for reliable assessment of patients' fertility. Finally, we believe that radiological procedures are not indicated or justified when prolonged catheterisation with elevated gonadic irradiation is needed.

Topics: Adolescent; Adult; Angiography; Catheterization, Peripheral; Contraindications; Embolization, Therapeutic; Ethanol; Follicle Stimulating Hormone; Follow-Up Studies; Gonadotropins; Humans; Inhibins; Luteinizing Hormone; Male; Polidocanol; Polyethylene Glycols; Radiation Dosage; Radiography, Interventional; Sclerosing Solutions; Sclerotherapy; Seminal Vesicles; Sperm Count; Testosterone; Treatment Outcome; Ultrasonography, Doppler; Varicocele

Topics: Adult; Anatomy, Artistic; Child; Humans; Male; Medical Illustration; Polidocanol; Polyethylene Glycols; Postoperative Complications; Sclerosing Solutions; Sclerotherapy; Sperm Count; Varicocele

The retrograde sclerotherapy of the internal spermatic vein is a simple and safe method for the treatment of a varicocele. Approximately 5500 patients had so far undergone the interventional therapy in our departments. The methods of retrograde sclerotherapy will be described and alternative methods of treatment will be given in detail. The minor trauma, the low gonad dose and fast implementation coupled with a high success rate show that this method is very safe and efficient. We have, therefore, chosen it as the primary therapy.

Topics: Adolescent; Adult; Angiography; Child; Collateral Circulation; Contraindications; Humans; Male; Phlebography; Polidocanol; Polyethylene Glycols; Radiography, Interventional; Recurrence; Safety; Sclerosing Solutions; Sclerotherapy; Testis; Treatment Outcome; Varicocele

To assess the results of our experience in correcting primary varicocele using a modified technique of antegrade scrotal sclerotherapy.. From December 1997 to February 2000, 201 patients with primary varicocele underwent antegrade scrotal sclerotherapy. Before treatment all patients were evaluated by a physical examination, colour Doppler ultrasonography of the spermatic cord, and abdominal and scrotal ultrasonography. Sperm samples were analysed only in patients aged > 18 years. The treatment was administered using a special venous catheter system with a Y-adapter. Complications after treatment and the rate of persistence of reflux were assessed 3 and 6 months after the antegrade scrotal treatment, by clinical examination and colour-Doppler ultrasonography of the spermatic cord.. The mean operative duration was 15 min; there were no significant complications during treatment and all patients were discharged within 4 h. Complications after treatment occurred in 10 of the 201 patients (5%); four patients had epididymo-orchitis, three a scrotal haematoma, one a surgical wound infection, one persistent scrotal pain and one persistent flank pain on the same side as the surgery. Reflux was persistent in 12 patients (6%).. Antegrade scrotal sclerotherapy is a simple, minimally invasive and highly effective technique for blocking spermatic vein reflux, with a low rate of complications. The technical changes simplified the cannulation of the spermatic vein and facilitated antegrade phlebography and sclerotherapy using the air-block technique.

Topics: Adolescent; Adult; Catheterization, Peripheral; Child; Humans; Infusions, Intravenous; Male; Middle Aged; Patient Satisfaction; Polidocanol; Polyethylene Glycols; Prospective Studies; Sclerosing Solutions; Sclerotherapy; Sperm Count; Sperm Motility; Treatment Outcome; Varicocele

The aim of this study was to evaluate surgical complications and the outcome of grade II and III varicoceles treated with Tauber's antegrade scrotal sclerotherapy.. A total of 21 patients with a median age of 13 (range, 10 to 21) years and left-sided grade II and III varicoceles were treated with Tauber's antegrade scrotal sclerotherapy and underwent follow-up over a median period of 23 months (range, 9 to 35).. One grade II varicocele persisted after antegrade sclerotherapy for 6 months. After a second sclerotherapy 6 months later, no further recurrence was detected. One patient with a grade II to III varicocele had a grade I varicocele recurrence 14 months after operation. Three patients showed a slight hydrocele postoperatively.. This limited series indicates that Tauber's antegrade scrotal sclerotherapy is a safe and effective treatment for grade II and III varicoceles in children and adolescents.

Topics: Adolescent; Child; Humans; Male; Polidocanol; Polyethylene Glycols; Sclerosing Solutions; Sclerotherapy; Scrotum; Varicocele

To test the efficacy of antegrade scrotal sclerotherapy (ASS) for the treatment of varicocele in teenagers.. The study included 38 patients (mean age 14.9 years, range 12-18) with left-sided varicocele. Three patients had a grade 1 varicocele, 22 were grade 2 and 13 were grade 3. ASS was performed under local anaesthesia on an out-patient basis.. ASS was accepted by all patients except one. There were no peri-operative problems and only one patient developed post-operative epididymitis. During 9 to 15 months of follow-up (mean 11 months), only two patients developed persistence of a lower grade of varicocele.. This study illustrates that ASS is a safe and successful out-patient procedure for the treatment of varicocele in teenagers.

Topics: Adolescent; Follow-Up Studies; Humans; Injections, Intravenous; Male; Polidocanol; Polyethylene Glycols; Sclerotherapy; Treatment Outcome; Varicocele

The antegrade scrotal sclerotherapy is a minimally invasive surgical technique in the treatment of the varicocele. Through a small scrotal incision a straight vein merging in the spermatic vein is isolated and cannulated. An antegrade phlebography is performed and ethoxysclerol is injected in the vein. We have performed this technique in 35 patients with a follow-up of at least 3 months. All patients except one (97%) show no more varicocele. This technique has a low morbidity, is cheap and as effective as the other treatment modalities. The antegrade sclerotherapy is competitive to the retrograde embolisation and has the advantage that the treatment can be performed in all cases, even in cases of recidive.

Topics: Adolescent; Adult; Humans; Male; Phlebography; Polidocanol; Polyethylene Glycols; Recurrence; Sclerosing Solutions; Spermatic Cord; Varicocele; Veins

Topics: Catheterization, Peripheral; Fatty Acids; Humans; Male; Polidocanol; Polyethylene Glycols; Punctures; Radiography, Interventional; Sclerosing Solutions; Sclerotherapy; Testis; Varicocele; Veins

252 consecutive patients with left-sided idiopathic varicocele were admitted into this prospective study. 30 patients did not receive a transcatheter sclerotherapy on account of their venous morphology on the selective phlebogram. Ultrasound examinations including Doppler sonography were performed before and 1, 3, and 6 to 12 (average 10) months after transcatheter sclerotherapy of the varicocele. For evaluation of therapeutic success the maximal diameter of the pampiniform plexus, the maximal diameter of the largest vein of the plexus, and, by means of Doppler ultrasound, reflux were measured. A continual decrease of these parameters was observed approximately one year after sclerotherapy. 9% of patients (20 patients) had a persisting varicocele. A premature decision for repeat sclerotherapy or operative correction of possibly persisting varicoceles can be avoided by employing a sonographical follow-up of more than 10 months.

Topics: Adolescent; Adult; Child; Follow-Up Studies; Humans; Male; Middle Aged; Polidocanol; Polyethylene Glycols; Recurrence; Sclerotherapy; Ultrasonography; Varicocele

Percutaneous occlusion of the spermatic vein has been performed on 136 consecutive patients with varicocele scroti during the last six years. The authors report their long-term results on the first 119 cases to have a follow-up of at least six months. Occlusion of the insufficient gonadal vein is induced by the selective transcatheter injection of sclerosing agent with local anesthesia. Their patients are always evaluated before and after the procedure by Doppler examination. A spermiogram is done before the procedure and after six months. In this series they registered only 4 recurrences with no major complications.

Topics: Follow-Up Studies; Humans; Male; Phlebography; Polidocanol; Polyethylene Glycols; Sclerosing Solutions; Sclerotherapy; Scrotum; Time Factors; Varicocele

Percutaneous transvenous treatment has become the elective therapy for varicocele because it is a simple, safe, economic and reliable procedure. The presence of proximal anastomoses connecting a competent valved spermatic trunk with the renal vein can be responsible for a varicocele and make its treatment difficult. In such cases; the valve of the spermatic venous trunk can be bypassed using an open-ended guidewire with a removable mandril core, and then injecting the sclerosing agent through the guide. Moreover, the guidewire can facilitate the insertion of the catheter through the competent valve, thus allowing the placement of Gianturco coils. During the past 12 months we have successfully treated 4 patients affected by varicocele with competent valved venous trunk using the open-ended guidewire.

Topics: Embolization, Therapeutic; Humans; Male; Phlebography; Polidocanol; Polyethylene Glycols; Sclerosing Solutions; Testis; Varicocele; Veins

Idiopathic varicocele is nowadays accepted as a "social disease" for both its high incidence among young men and its affecting male fertility. Screening is thus required for young people and, above all, early and definitive treatment. We have evaluated the effectiveness of percutaneous sclerotherapy, which has become a standard procedure, in spite of its recent introduction in interventional radiology. One hundred and thirty-nine percutaneous occlusions were performed on 147 patients with varicocele using a sclerosing agent--polidocanol--and stainless steel coils. The failure rate of percutaneous treatment was about 12%. Complications never required hospitalization or surgery; recurrence rate is 3.66%. The patients were followed 3, 6, 12 and 24 months by US and Doppler to survey recurrences, and sperm analysis to estimate the clinical results of percutaneous therapy in infertile patients. Statistical analysis with linear regression of data from spermiograms showed constant improvement in sperm count, sperm motility percentage, and sperm morphology percentage. Fertility index improvement was similar to that of surgical ligation. The radiation dose received by the patient is negligible. Percutaneous therapy represent thus the treatment of choice in case of varicocele: compared with surgery, it offers similar clinical results and a lower recurrence rate, and it can be performed on an outpatient basis. Surgery should be performed only when anatomic variants make percutaneous treatment not feasible.

Topics: Adolescent; Adult; Aged; Catheterization, Peripheral; Child; Embolization, Therapeutic; Evaluation Studies as Topic; Femoral Vein; Humans; Infertility, Male; Male; Middle Aged; Polidocanol; Polyethylene Glycols; Radiography; Recurrence; Sclerosing Solutions; Testis; Ultrasonography; Varicocele

The results of the treatment of 251 patients with varicocele are demonstrated. By means of spermiographic and histologic investigations the fertility-disturbing influence of this vascular disease of the testis shall be proved and the effect of the operative sanation shall be estimated. For many years the high ligature of the testicular vein has been favoured method of operation; since 1984 exclusively the percutaneous transfemoral occlusion of the testicular vein has been performed, when a left-sided varicocele is present. In 61% of the patients examined an improvement of the spermiogram is to be proved, in which case the most conspicuous rate of increase lies at the motility of spermatozoa with 58%. After removal if the varicocele the investigations of the testicular tissue reveal in 42% of the cases an improvement of the findings by decrease of the tubular atrophy and increase of the tubular cell number. Among the number of our patients the rate of conception is 49%. The treatment of varicocele is a fertility-protective measure and therefore should be performed in all adolescents and males at fertile age.

Topics: Adolescent; Adult; Aged; Biopsy; Child; Humans; Infertility, Male; Male; Middle Aged; Polidocanol; Polyethylene Glycols; Sperm Count; Sperm Motility; Spermatogenesis; Testis; Varicocele

Ninety-seven patients received transfemoral sclerotherapy of the spermatic vein for varicocele. After observation for 2 to 5 years, follow-up was available in 69 patients (71.2%), in 11 of whom the procedure failed (16.0%). Complications during angiography (N = 12, 12.4%) or sclerotherapy (N = 31, 32.0%) did not require hospital treatment. At least one parameter of the spermiogram was improved in 25 of 32 patients (78.1%). Forty-four of 69 patients (63.8%) treated because of a childless marriage, and whose wives were not known to be infertile, had a pregnancy rate of 47.7%. Thi method may be considered equal to surgical procedures in achieving venous occlusion; furthermore it is simple and can be used on an outpatient basis without anesthesia.

Topics: Adult; Catheterization; Female; Fertility; Follow-Up Studies; Humans; Male; Polidocanol; Polyethylene Glycols; Pregnancy; Sclerosing Solutions; Sperm Count; Sperm Motility; Spermatic Cord; Time Factors; Varicocele