Treatment of male varicoceles by transcatheter polidocanol foam sclerotherapy: evaluation of clinical success, complications, and patients' satisfaction with regard to alternative techniques.

Abstract

OBJECTIVES:

We report our experience with polidocanol foam sclerotherapy with no additional coils, evaluating clinical success, patients' satisfaction, and complications.

METHODS:

We conducted a retrospective study of 141 patients with 146 varicoceles (mean age: 29.3 years; range: 13 - 60 years) who underwent foam sclerotherapy with polidocanol 2% (range: 2 - 12 ml) in an outpatient setting between January 2007 and December 2013. For the follow-up, telephone interviews with the patients were conducted (mean follow-up time: 46.4 months, standard deviation: 20.17 months).

RESULTS:

The technical success rate was 91.8%. There was a 55.8% response rate to the telephone interviews. Follow-up revealed a clinical success rate of 83.9% and a persistence or relapse rate of 16.1%. Of the patients, 81.9% were absolutely satisfied with the outcome. In 94.9% of cases, pain or discomfort resolution was reported, and in 97% of cases, aesthetic issues were no longer a problem. Of partners, 63.2% achieved pregnancy, and in 50% of patients with preprocedural testicular atrophy, catch-up growth was observed. One patient with pampiniform plexus phlebitis received inpatient treatment with no long-term damage recorded.

CONCLUSIONS:

Polidocanol foam varicocele sclerotherapy is a safe and effective procedure, with a high rate of patients' satisfaction, clinical and technical success, and considerable catch-up growth and pregnancy achievement.

KEY POINTS:

• Varicocele treatment using polidocanol foam sclerotherapy is a safe and effective procedure. • It is easily feasible in an outpatient setting. • The clinical and technical success rates are high. • It shows a high rate of patients' satisfaction and symptom resolution. • Postinterventional catch-up growth and pregnancy achievement are considerable.

• Authors: Alma Ali, Stefan Wirth, Karla Maria Treitl, Marcus Treitl
• Journal: European radiology (Eur Radiol) Vol. 25 Issue 10 Pg. 2889-97 (Oct 2015) ISSN: 1432-1084 [Electronic] Germany
• PMID: 25796582 (Publication Type: Journal Article, Observational Study)

Chemical References

• Sclerosing Solutions
• Polidocanol
• Polyethylene Glycols

Topics

• Adolescent
• Adult
• Atrophy (pathology)
• Catheterization (methods)
• Feasibility Studies
• Humans
• Male
• Middle Aged
• Patient Satisfaction
• Polidocanol
• Polyethylene Glycols (administration & dosage, adverse effects)
• Recurrence
• Retrospective Studies
• Sclerosing Solutions (administration & dosage, adverse effects)
• Sclerotherapy (adverse effects, methods)
• Testis (pathology)
• Treatment Outcome
• Varicocele (therapy)
• Young Adult