sodium-morrhuate and Varicocele

Adolescent varicocele has been shown to affect spermatogenesis and correlate with decreased ipsilateral testicular volume, prompting treatment in a select population. We report our experience with 3 varicocele ligation procedures in concordance with sclerotherapy in adolescent patients.. A total of 120 males underwent varicocele surgery at our institutions during an 8-year period. Sodium morrhuate sclerotherapy was used in 91 patients and 73 adolescent males fulfilled the 6-month followup criteria. The 73 males who were 9 to 17 years old underwent a total of 75 (bilateral in 2) procedures for varicocele treatment. Of the patients 23 underwent subinguinal microscopic varicocelectomy (group 1), 9 underwent loupe assisted subinguinal varicocelectomy (group 2) and 41 underwent loupe assisted inguinal varicocelectomy (group 3). All patients received intraoperative sclerotherapy using sodium morrhuate injection. Outcome measures included recurrence, complications and catch-up growth at a minimum of 6 months of followup.. The varicocele recurrence rate was 2.7% in patients receiving combined surgical ligation and sclerotherapy ablation. Group 1 had 2 recurrent varicoceles and no hydrocele formation, group 2 had no varicocele recurrence and no hydrocele formation, and group 3 had no varicocele recurrence and 2 postoperative hydroceles. Catch-up growth in the ipsilateral testis was seen in 85% of patients. No atrophy or testicular loss was noted.. This preliminary experience with combined surgical ligation and sclerotherapy ablation in the adolescent population resulted in low varicocele recurrence with minimal morbidity. Outcomes of loupe assisted varicocelectomy appear to be improved compared to those in previous studies, alluding to an advantage in the addition of sclerotherapy.

Topics: Adolescent; Child; Humans; Intraoperative Period; Ligation; Male; Sclerosing Solutions; Sclerotherapy; Secondary Prevention; Sodium Morrhuate; Treatment Outcome; Urologic Surgical Procedures, Male; Varicocele

Between december 1983 and april 1989, percutaneous retrograde sclerotherapy of varicocele was successfully performed on 364 patients. A 5% solution of sodium morrhuate and benzylic alcohol (Varicocid) was administered through a coaxial balloon catheter inserted into the spermatic vein. 10 of the patients had relapses after surgery. Long-term follow-up was available for 268 patients (73.6%). Three of them had incomplete relapses after sclerotherapy. In terms of spermatologic improvement, sclerotherapy appeared to be effective in the treatment of varicoceles. In our experience, sclerotherapy is a safe effective procedure to be preferred to surgery in the management of varicocele.

Topics: Adolescent; Adult; Benzyl Alcohols; Child; Child, Preschool; Follow-Up Studies; Humans; Injections, Intravenous; Male; Middle Aged; Phlebography; Recurrence; Sclerotherapy; Sodium Morrhuate; Sperm Count; Sperm Motility; Varicocele

Of 31 boys 10 to 16 years old referred for treatment of a left grade II or III varicocele 28 underwent percutaneous sclerotherapy. Due to anatomical and technical obstacles sclerotherapy was not possible in 3 boys. At follow-up 1 of 16 boys (6.2 per cent) had a mild recurrence detected by Doppler sonography of the spermatic cord. Percutaneous sclerotherapy had no serious side effects, and proved to be an efficient and convenient treatment of left varicocele in childhood.

Topics: Adolescent; Child; Humans; Male; Phlebography; Sclerosing Solutions; Sodium Morrhuate; Varicocele

Vague notions concerning the radiation dose to the gonads during sclerosing treatment of varicoceles have lead to the unjust neglect of this form of therapy. Accurate measurements have shown that the dose is less than the dose to the female breast resulting from chest radiographs in two planes, if the treatment proceeds without complication. Although the dose is so low, an attempt has been made to evaluate the risk.

Topics: Humans; Male; Models, Structural; Radiation Dosage; Radiation Monitoring; Radiography; Risk; Sclerosing Solutions; Sodium Morrhuate; Testis; Varicocele