Sixty-eight patients with unilateral left-sided idiopathic
varicocele who had not been treated previously were examined with Doppler sonography before and 1, 3, and 12 months after selective venography with balloon occlusion and transcatheter
sclerotherapy of the internal spermatic vein.
Varicocele and its persistence or recurrence was diagnosed by reflux only. Reflux was differentiated into stop-type and shunt-type by Doppler sonography. The resolution of
varicocele was defined by absence of any reflux. The rate of resolution was greatest 3 months after
sclerotherapy (49 patients, 72%). The diagnosis of persisting or recurring
varicocele at this time does not seem to be justified, however, as in our study both further improvement and deterioration were observed up to 12 months
after treatment. Twenty patients (29%) had a persisting or recurring
varicocele 12 months after
sclerotherapy. Reflux is the parameter of significance for diagnosing
varicocele and its persistence or recurrence after
therapy. Improvement of clinical aspects of
varicocele (e.g., sperm count, sperm motility, and conception rates) depends on
therapy of even subclinical
varicoceles. Therefore, diagnosis and
retreatment of persistent or recurrent
varicoceles seems essential. The high sensitivity of Doppler sonography permits adequate assessment of the therapeutic result and evaluation of real rates of persistent or recurrent
varicoceles after venography with balloon occlusion and transcatheter
sclerotherapy.