Four Years' Follow-up Results of Three Different Percutaneous Treatments for Male Varicocele

Abstract

Objective:

To evaluate the efficacy of three different interventional radiological procedures for the treatment of venous reflux in symptomatic male varicocele.

Design:

Prospective study with a 48-month colour duplex ultrasound (CD) follow-up.

Setting:

Department of Radiology, Tor Vergata University of Rome.

Patients:

From January 1991 to December 1993, 45 symptomatic patients with third- to fourth-degree varicocele, according to Sarteschi's CD classification, were randomly divided into three equal groups (15 patients each).

Interventions:

The first group received sclerotherapy (Athoxysclerol), the second underwent embolisation (Gianturco coils), while the third group received combined sclero–embolisation therapy (Athoxysclerol and Gianturco coils).

Main outcomes measures:

The frequency of recurrence for each procedure.

Results:

Two recurrences (13%) after 1 and 2 years occurred in patients who underwent sclerotherapy. In the embolisation group, two patients showed residual varices (13%). Neither recurrence nor residue was seen in the third group, who received combined therapy.

Conclusions:

Sclerotherapy provides good immediate results but drug dilution may cause a relapse shortly after treatment. Embolisation has a lower immediate success but better long-term success. Combined treatment provides the highest long-term success rate.