British journal of urology · 1996
Post-surgical recurrent varicocele: efficacy of internal spermatic venography and steel-coil embolization.
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Punekar S V, Prem A R, Ridhorkar V R, Deshmukh H L, Kelkar A R
Аннотация
OBJECTIVE: To delineate the venographic anatomy of the varicoceles which recur following conventional inguinal varicocele ligation and to determine the therapeutic efficacy of steel-coil embolization as assessed by improvements in seminal parameters and paternity.
PATIENTS AND METHODS: Thirty-nine patients with post-surgical recurrent varicoceles underwent bilateral internal spermatic venography approached through the right femoral vein. The collateral venous channels were identified and occluded using appropriate sizes of steel coils.
RESULTS: The procedure was technically successful in 33 patients (85%). Analysis of the 33 venograms showed a unilateral left-sided recurrent varicocele in 28 patients (85%) and bilateral recurrent varicoceles in five patients (15%). The mid and lower parallel collateral channels were observed in 27 patients (82%). The recurrences were treated easily with stainless steel-coil embolization. Five patients were lost to follow-up. Of the remaining 28 patients the sperm count and motility became normal in 16 (57%); only the motility improved in three patients (10%) while in nine patients (33%) there were no changes in either of the seminal parameters. Five patients achieved paternity.
CONCLUSIONS: Internal spermatic venography allowed a precise anatomical definition of the recurrent varicocele and the use of steel-coil embolization provided satisfactory improvements in sperm quality and paternity.
PATIENTS AND METHODS: Thirty-nine patients with post-surgical recurrent varicoceles underwent bilateral internal spermatic venography approached through the right femoral vein. The collateral venous channels were identified and occluded using appropriate sizes of steel coils.
RESULTS: The procedure was technically successful in 33 patients (85%). Analysis of the 33 venograms showed a unilateral left-sided recurrent varicocele in 28 patients (85%) and bilateral recurrent varicoceles in five patients (15%). The mid and lower parallel collateral channels were observed in 27 patients (82%). The recurrences were treated easily with stainless steel-coil embolization. Five patients were lost to follow-up. Of the remaining 28 patients the sperm count and motility became normal in 16 (57%); only the motility improved in three patients (10%) while in nine patients (33%) there were no changes in either of the seminal parameters. Five patients achieved paternity.
CONCLUSIONS: Internal spermatic venography allowed a precise anatomical definition of the recurrent varicocele and the use of steel-coil embolization provided satisfactory improvements in sperm quality and paternity.