Results of the percutaneous retrograde embolization as the first choice in the treatment of varicocele

• Published in: Cirugía pediátrica Vol. 22; no. 3; p. 128
• Main Authors: Piñera, J Gonzálvez, Fernández-Córdoba, M S, Anselmi, E Hernández, Mollá, E Juliá, Jiménez, M J Pedrosa, Cabañero, A G Blanco, Baró, A Palma
• Format: Journal Article
• Language: Spanish
• Published: Spain 01.07.2009
• Subjects: Adolescent; Child; Embolization, Therapeutic - methods; Humans; Male; Varicocele - therapy
• ISSN: 0214-1221

There is evidence that early varicocele treatment decreases testicular damage. The minimally invasive techniques such as laparoscopic varicocelectomy, antegrade sclerotherapy and percutaneous retrograde embolisation, are acquiring greater significance in the treatment of this disease. Since 1994, a series of 51 children, aged 7-16 years (mean, 12.9 years), with left-sided varicocele grades 2 (47%) and 3 (53%) were treated in our institution by percutaneous retrograde embolisation using coils. The right basilica vein was the most widely used (70%) followed by the right femoral vein. Seven children (13.7%) had complications: perforation of internal spermatic vein was the most frequent and treated conservatively. No child presented hydrocele after radiological procedures. Embolisation was accomplished succesfully at the first attempt in 35 (68.6%) of the 51 children and in 45 (88.2%) after a second embolisation. The follow-up ranges from 7 months to 5 ? years (mean, 1.8 years). The patients were monitored with clinical and doppler ultrasound examination 3, 6 and 12 months after the treatment. Retrograde embolisation is a safe and efficient minimally invasive treatment for correcting varicoceles in children. We performed retrograde embolisation as first choice of varicocele treatment in children; a second embolisation or conventional surgery for primary failure or late recurrence should be considered.