Endovascular Sclerotherapy for Male Varicoceles: A Retrospective Analysis of 1619 Patients

Purpose: To retrospectively evaluate safety and efficacy (resolution of pain, recurrence rate, improvement in sperm counts and motility) after transcatheter sclerotherapy using Lauromacrogrol 400 in 1619 consecutive patients. Material and Methods: The institutional review board approved the study and informed consent was obtained. A retrospective analysis was conducted on 1646 procedures using sclerotherapy performed on 1619 male patients (mean age 29.4 years; range 12.3−65.5 years) with varicoceles during twelve years (from 1998 to 2010). Suspicious testicular veins were catheterized via a right femoral vein approach. Sclerosis of affected veins was induced by a slow injection of a liquid sclerosing agent (Lauromacrogol 400; Kreussler Pharma, Wiesbaden, Germany). Patients were discharged after 6 hours of observation. Follow-up was performed with ultrasound (US)-Doppler 30 days after the procedure. Post-procedure semen analysis was available for 56.4 % of patients. Results: Catheterisation and sclerotherapy were possible in 1613 of 1646 procedures (98%). No major periprocedural complications occurred. Recurrence was found on US-Doppler follow-up in 30 patients (1.9%). All were retreated: 27 (90%) by using the same percutaneous technique and three by surgery. Post-sclerotherapy semen analysis (available for 56.4% of patients) showed significant improvements in sperm counts (mean 7.9 +/- 3.8 million sperm/mL; p<0.005) and motility (7.2 +/- 2.1%; p<0,005). Conclusion: Percutaneous sclerotherapy is a safe and minimally invasive technique treating for varicoceles in men.