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Transcatheter foam sclerotherapy of symptomatic female varicocele with sodium-tetradecyl-sulfate foam.

Abstract
To evaluate the efficacy of transcatheter foam sclerotherapy (TCFS) in pelvic varicocele using sodium-tetradecyl-sulfate foam (STSF), we conducted a retrospective study in 38 patients (mean age, 36.9 years; range, 22-44 years) with pelvic congestion syndrome (PCS) treated between January 2000 and June 2005 by TCFS. Pelvic pain was associated with dyspareunia in 23 (60.5%) patients, urinary urgency in 9 (23.7%) patients, and worsening of pain during menstruation and at the end of a day of work in 7 (18.4%) and 38 (100%) patients, respectively. Diagnosis was made by pelvic and transvaginal color Doppler ultrasound examination, demonstrating ovarian or pelvic varices with a diameter >5 mm presenting venous reflux. TCFS was performed in all patients, using 3% STSF. Follow-up was performed by physical examination, pelvic and transvaginal Doppler ultrasound examination and by a questionnaire-based assessment of pain at 1, 3, 6, and 12 months after the procedure. Technical success was achieved in all patients (100%). In three patients a pelvic colic-like pain occurred immediately after sclerotic agent injection, disappearing spontaneously after a few minutes. No recurrent varicoceles were observed during a 12-month follow-up. A statistically significant improvement in each category of specific symptoms was observed at 1, 3, 6, and 12 months after the procedure. We conclude that TCFS of female varicocele using a 3% STSF is safe and effective for the treatment of PCS. It is associated with a significant reduction of symptoms and can be regarded as a valid alternative to other endovascular and surgical techniques.
AuthorsRoberto Gandini, Marcello Chiocchi, Daniel Konda, Enrico Pampana, Sebastiano Fabiano, Giovanni Simonetti
JournalCardiovascular and interventional radiology (Cardiovasc Intervent Radiol) 2008 Jul-Aug Vol. 31 Issue 4 Pg. 778-84 ISSN: 1432-086X [Electronic] United States
PMID18172712 (Publication Type: Journal Article)
Chemical References
  • Sclerosing Solutions
  • Sodium Tetradecyl Sulfate
Topics
  • Adult
  • Catheterization (methods)
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Ovary (blood supply)
  • Pain Measurement
  • Patient Satisfaction
  • Pelvis (blood supply, physiopathology)
  • Phlebography (methods)
  • Probability
  • Retrospective Studies
  • Risk Assessment
  • Sclerosing Solutions (administration & dosage)
  • Sclerotherapy (methods)
  • Severity of Illness Index
  • Sodium Tetradecyl Sulfate (therapeutic use)
  • Treatment Outcome
  • Varicose Veins (diagnostic imaging, therapy)

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