[Varicocele in adolescents. Treatment by sclerotherapy and percutaneous embolization: reflections on the method. Apropos of 23 cases]. 1998

C Lopez, and O Serres-Cousine, and M Averous
Service d'Urologie II, CHU Lapeyronie, Montpellier, France.

OBJECTIVE The authors report their experience of the treatment of varicocele in adolescents. As a result of progress in interventional radiology and embolization techniques, they have used a technique combining sclerotherapy and percutaneous embolization since 1993. METHODS Since 1993, twenty three adolescents between the ages of 11 and and 17 years (mean = 14.5 years) were treated percutaneously for grade II and II left varicocele. The operation was performed under local anaesthesia and/or neuroleptanalgesia. Phlebography by selective catheterization of the left spermatic vein was performed for anatomical assessment (ostial incontinence, collateral vessels). Embolization was then performed under fluoroscopic control by injection of a sclerosing liquid, sodium tetradecyl sulphate (Trombovar), and systematically completed by insertion of endovascular occlusive metal coils. RESULTS The follow-up ranged from 6 to 48 months (mean = 30 months). The follow-up clinical and ultrasound examination showed complete disappearance of the varicocele in 22 cases (95% of cases), with a persistent grade I asymptomatic left varicocele in 1 case. No complications were observed. The mean hospital stay was 48 hours. CONCLUSIONS This constitutes a rapid method, which is minimally traumatic for the adolescent. Its efficacy is comparable to that of classical surgical techniques with lasting results. Insertion of coils is the endovascular equivalent of surgical ligation of the pathological vein. The liquid embolus is particularly useful as it diffuses and scleroses collateral veins, responsible for recurrence. The advantage of this method resides in a better understanding of the reflux mechanisms, allowing the procedure to be adapted to the venous anatomy. This technique ensures treatment of complex varicoceles, such as postsurgical recurrences.

UI MeSH Term Description Entries
D008297 Male Males
D010690 Phlebography Radiographic visualization or recording of a vein after the injection of contrast medium. Venography,Phlebographies,Venographies
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D004621 Embolization, Therapeutic A method of hemostasis utilizing various agents such as Gelfoam, silastic, metal, glass, or plastic pellets, autologous clot, fat, and muscle as emboli. It has been used in the treatment of spinal cord and INTRACRANIAL ARTERIOVENOUS MALFORMATIONS, renal arteriovenous fistulas, gastrointestinal bleeding, epistaxis, hypersplenism, certain highly vascular tumors, traumatic rupture of blood vessels, and control of operative hemorrhage. Embolotherapy,Therapeutic Embolization,Embolizations, Therapeutic,Embolotherapies,Therapeutic Embolizations
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000279 Administration, Cutaneous The application of suitable drug dosage forms to the skin for either local or systemic effects. Cutaneous Drug Administration,Dermal Drug Administration,Drug Administration, Dermal,Percutaneous Administration,Skin Drug Administration,Transcutaneous Administration,Transdermal Administration,Administration, Dermal,Administration, Transcutaneous,Administration, Transdermal,Cutaneous Administration,Cutaneous Administration, Drug,Dermal Administration,Drug Administration, Cutaneous,Skin Administration, Drug,Administration, Cutaneous Drug,Administration, Dermal Drug,Administration, Percutaneous,Administrations, Cutaneous,Administrations, Cutaneous Drug,Administrations, Dermal,Administrations, Dermal Drug,Administrations, Percutaneous,Administrations, Transcutaneous,Administrations, Transdermal,Cutaneous Administrations,Cutaneous Administrations, Drug,Cutaneous Drug Administrations,Dermal Administrations,Dermal Drug Administrations,Drug Administrations, Cutaneous,Drug Administrations, Dermal,Drug Skin Administrations,Percutaneous Administrations,Skin Administrations, Drug,Skin Drug Administrations,Transcutaneous Administrations,Transdermal Administrations
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000367 Age Factors Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time. Age Reporting,Age Factor,Factor, Age,Factors, Age
D012597 Sclerosing Solutions Chemical agents injected into blood vessels and lymphatic sinuses to shrink or cause localized THROMBOSIS; FIBROSIS, and obliteration of the vessels. This treatment is applied in a number of conditions such as VARICOSE VEINS; HEMORRHOIDS; GASTRIC VARICES; ESOPHAGEAL VARICES; PEPTIC ULCER HEMORRHAGE. Injections, Sclerosing,Sclerosant,Sclerosing Agent,Sclerosing Agents,Sclerosing Injection,Sclerosing Solution,Sclerosants,Sclerosing Drugs,Sclerosing Injections,Agent, Sclerosing,Agents, Sclerosing,Drugs, Sclerosing,Injection, Sclerosing,Solution, Sclerosing,Solutions, Sclerosing

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