Radiology, Vol 164, 161-168, Copyright © 1987 by Radiological Society of North America
Idiopathic varicoceles: feasibility of percutaneous sclerotherapy
G Sigmund, W Bahren, H Gall, M Lenz and W Thon
Percutaneous retrograde venography was performed in 717 patients with a
left-sided idiopathic varicocele. In 674 (94.0%), testicular (internal
spermatic) vein insufficiency was proved by contrast medium reflux from the
left renal vein into the testicular vein, down to the pampiniform plexus.
The different venographic patterns of the testicular veins were classified
into seven basic types. Five of these, comprising 624 patients, had
incompetent or missing valves all along the trunk of the testicular vein.
In 554 of the 624 (88.8%), sclerotherapy was performed, but such treatment
was possible in only three of 50 patients with a competent orifice valve
bypassed by an insufficient collateral (type IVb). In 43 of the 717
patients (6.0%), no insufficient vein could be found at all (type 0). The
mean fluoroscopy time was 4.4 minutes. There were no serious complications
associated with venography or sclerotherapy, and the initial recurrence
rate was 9.8%. Percutaneous sclerotherapy is therefore a simple, safe, and
effective treatment of testicular vein insufficiency and is suitable for
almost 80% of patients with varicoceles.
