Treatment of symptomatic high-flow female varicoceles with stop-flow foam sclerotherapy.

Abstract

PURPOSE:

To assess the efficacy of stop-flow foam sclerotherapy (SFFS) in high-flow pelvic varicoceles using 3 % sodium tetradecyl sulfate (STS) foam.

METHODS:

Our institutional review board granted approval and waived informed consent for this retrospective study of 26 patients (mean age 37.3 years, range 23-46 years) with pelvic congestion syndrome (PCS) who had high-outflow venous collaterals treated by SFFS between June 2005 and June 2011 in our department. PCS was diagnosed by physical and transvaginal color Doppler ultrasound examination, while high-outflow venous collaterals were detected at selective ovarian venography. SFFS was performed by injection of 3 % STS foam into the pelvic varices after balloon occlusion of the major venous vessels (hypogastric and/or ovarian veins) to which the high-outflow venous collaterals were tributary. Follow-up was performed at 1, 3, 6, and 12 months by physical and transvaginal color Doppler ultrasound examination and by a questionnaire-based assessment of pain using a symptom severity score.

RESULTS:

The procedure was technically successful in all patients. After the injection of 3 % STS foam, all patients had a colic like pain that spontaneously resolved after 5 min. During follow-up, no recurrences of PCS were detected. Significant improvement of symptoms (Student's t test P < 0.01) was observed at 1, 3, 6, and 12 months.

CONCLUSION:

SFFS using 3 % STS foam is a safe and effective treatment for high-flow female varicoceles and should be considered as an alternative to other endovascular and surgical options.

• Authors: Roberto Gandini, Daniel Konda, Sergio Abrignani, Marcello Chiocchi, Valerio Da Ros, Daniele Morosetti, Giovanni Simonetti
• Journal: Cardiovascular and interventional radiology (Cardiovasc Intervent Radiol) Vol. 37 Issue 5 Pg. 1259-67 (Oct 2014) ISSN: 1432-086X [Electronic] United States
• PMID: 24190634 (Publication Type: Journal Article)

Chemical References

• Sclerosing Solutions
• Sodium Tetradecyl Sulfate

Topics

• Adult
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Ovary (blood supply)
• Pelvic Pain (etiology, therapy)
• Pelvis (blood supply)
• Phlebography (methods)
• Retrospective Studies
• Sclerosing Solutions (therapeutic use)
• Sclerotherapy (methods)
• Sodium Tetradecyl Sulfate (therapeutic use)
• Syndrome
• Treatment Outcome
• Ultrasonography, Doppler, Color (methods)
• Varicose Veins (complications, therapy)