Follow-up of varicocele treated with percutaneous retrograde sclerotherapy: Technical, clinical and seminal aspects

Abstract

Varicocele is a common cause of male infertility; it can be treated by percutaneous retrograde embolization of the internal spermatic vein in order to improve sperm parameters and male fertility. The aim of this study was to verify the improvement of semen parameters after varicocele retrograde sclerotherapy. We evaluated 223 patients with left (206) or bilateral (17) varicocele (mean age +/- SD, 27.3 +/- 4.7 yr, range 18-37) by clinical, Doppler and seminal examinations; all the patients underwent phlebography, using 5F Cobra catheter from the right femoral vein access to the internal spermatic vein and varicocele sclerosing with Hydroxy-polyaethoxydodecanol. Doppler and seminal examinations 6 months after sclerotherapy were requested for the follow-up. Sixty-seven patients with left or bilateral varicocele who did not undergo sclerotherapy were studied as controls. Six months after sclerotherapy, a complete resolution of left varicocele was present in 172 patients (77.1%), while a partial improvement was obtained in 34 patients (15.3%). In these 206 patients seminal examination showed a significant improvement of sperm concentration (mean +/- SEM, 52.1 +/- 4.1 vs 44.2 +/- 3.6 million/ml, p = 0.002) and progressive motility (40.5 +/- 2.2 vs 33.3 +/- 2.0%, p = 0.0001), but not of normal sperm morphology (38.9 +/- 2.3 vs 37.4 +/- 2.1%, ns). In the control group no significant variations of seminal parameters were observed 6 months after the basal examination. In conclusion, varicocele retrograde sclerotherapy is a well-tolerated technique with a low cost-benefit ratio, able to improve semen parameters.

Varicocele sclerotherapy improves serum inhibin B levels and seminal parameters

“…, 1997). In our experience this technique has proved to be highly effective in a large cohort of patients which improved sperm concentration and progressive motility in comparison with untreated patients (Di Bisceglie et al. , 2003).…”

“…Hydroxy‐polyaethoxy‐dodecanol (Aethoxysclerol) at 2 or 3% was mixed with the contrast medium in order to monitor its retrograde progression into the vein. Further details concerning the percutaneous sclerotherapy procedures have been already published (Di Bisceglie et al. , 2003).…”

“…, 2003). We have previously described that varicocele treatment through percutaneous retrograde embolization of the internal spermatic vein is able to improve sperm concentration and progressive motility in comparison with untreated patients (Di Bisceglie et al. , 2003).…”

Comparison of Inguinal Approach, Scrotal Sclerotherapy and Subinguinal Antegrade Sclerotherapy in Varicocele Treatment: A Randomized Prospective Study

“…Mann-Whitney test and Kruskal-Wallis test were used for nonparametric measures. Cross tables, 2 tests and the correlation coefficient were performed to compare ordinal data. Significance was set at p !…”

“…Retrograde sclerotherapy is a rather simple technique which is able to improve semen parameters [2] ; however, it is still rather expensive, requiring special equipment and skills. Antegrade scrotal sclerotherapy of the spermatic vein is an easy technique that can be performed rapidly with local anesthesia and is effective with a low complication rate [3] .…”