Tolerance of glue embolization under local anesthesia in varicoceles: a comparative study of two different cyanoacrylates

Eur J Radiol. 2014 Mar;83(3):559-63. doi: 10.1016/j.ejrad.2013.11.018. Epub 2013 Dec 3.


Purpose: To find out whether in varicocele embolization the copolymer cyanoacrylate glue (NBCA-MS) has a better patient tolerance compared to the monomer n-butyl-2-cyanoacrylate (NBCA).

Materials and methods: N=112 insufficient spermatic veins (left sided N=84, right sided N=28) diagnosed in N=83 adult males were prospectively randomized for blinded embolization with either NBCA N=54 (Histoacryl) or with NBCA-MS N=58 (Glubran2). Before, during and up to one week after embolization, patient discomfort was assessed by a standardized pain scale. Type, location and side of discomfort were noted. Statistical analysis was performed with the Mann-Whitney U-test, the McNemar test and the Fisher's exact test.

Results: Embolization caused discomfort in N=48/112 (43%) spermatic veins, comprising N=26/54 (48%) in the NBCA group and N=22/58 (38%) in the NBCA-MS group. During the week after embolization, the overall number of discomfort reports rose to N=62/106 (59%), with an increase to N=30/53 (57%) in the NBCA group and to N=32/53 (60%) in the NBCA-MS group. The number of immediate grade 2 to 4 pain reactions was N=22/112 (20%), and rose to N=37/106 (35%) after one week. No difference in discomfort during embolization and at 1 week after treatment was noted. Characteristics, severity grading, and location of discomfort were similar in both NBCA groups, regardless the time point of observation.

Conclusion: Discomfort after glue embolization of varicocele is a common side effect, which might evolve to pain. The assumed lower inflammatory reaction on NBCA-MS was not translated in an improved tolerance.

Keywords: Embolization; Varicocele; n-Butylcyanoacrylate.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anesthetics, Local / therapeutic use
  • Double-Blind Method
  • Embolization, Therapeutic / adverse effects
  • Embolization, Therapeutic / methods*
  • Enbucrilate / adverse effects*
  • Enbucrilate / classification
  • Enbucrilate / therapeutic use*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain / diagnosis
  • Pain / etiology*
  • Pain / prevention & control
  • Pain Measurement / drug effects
  • Tissue Adhesives / adverse effects*
  • Tissue Adhesives / therapeutic use*
  • Treatment Outcome
  • Varicocele / diagnosis
  • Varicocele / therapy*
  • Young Adult


  • Anesthetics, Local
  • Tissue Adhesives
  • Enbucrilate