Percutaneous transfemoral sclerotherapy versus surgery in the management of varicocele

ABSTRACT

In this study percutaneous transfemoral sclerotherapy was compared to surgical ligation through the inguinal approach to evaluate its place in the management of left varicocele. Sclerotherapy, in contrast to surgery, was done under local anaesthesia as a day case procedure. Its complications are minor and transient. Venography provided excellent mapping of the venous tree and sclerotherapy cou!d be done at the time of diagnosis, However, There was a failure of occlusion and varicocele persistence rate of 22% among the 41 patients in whom sclerotherapy was attempted. None of the 45 patients treated surgically had recurrence or persistence of the varicocele. The percentage of patients showing improved sperm count and motility after surgery and successful sclerotherapy was comparable. It was concluded in this study that sclerotherapy is the treatment of choice of subclinical varicocele and recurrent cases after inguinal or scrotal surgical approaches. Clinically detectable and recurrent varicoceles after suprainguinal ligation operation or sclerotherapy are better treated surgically