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

Eur Radiol. 2015 Oct;25(10):2889-97. doi: 10.1007/s00330-015-3684-5. Epub 2015 Mar 22.

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.

Publication types

  • Observational Study

MeSH terms

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

Substances

  • Sclerosing Solutions
  • Polidocanol
  • Polyethylene Glycols