RESUMEN
The treatment of varicocele is controversial in boys and it is a contributing factor to male infertility. Recently it has been proposed that earlier therapy of a varicocele during this period may improve the prognosis of infertility. We review our experience with the diagnosis and management of left varicocele in 30 pediatric patients 6 to 15 years old. All patients had clinically palpable varicocele. All were managed under local anesthesia by spermatic venography and percutaneous transcatheter embolization of the internal spermatic vein with spring coils. All achieved satisfactory occlusion, and during the follow up from 13 years to 9 months there was only one recurrence, noted in a patient 6 months after the procedure. Internal spermatic venograms allowed precise coil placement relative to collateral veins which could cause recurrence. Complications developed were phlebitis of the pampiniform plexus, leading to swelling and erythema of the left scrotum and mild flank pain, these symptoms resolved without sequelae. This a safe and effective nonsurgical method of obliterating varicoceles in children.
Asunto(s)
Embolización Terapéutica/métodos , Flebografía/métodos , Testículo/cirugía , Varicocele/cirugía , Adolescente , Niño , Lateralidad Funcional , Humanos , Infertilidad Masculina/etiología , Masculino , Complicaciones Posoperatorias , Testículo/fisiopatología , Varicocele/complicaciones , Varicocele/fisiopatologíaRESUMEN
The treatment of varicocele is controversial in boys and it is a contributing factor to male infertility. Recently it has been proposed that early therapy of a varicocele during childhood or adolescence may improve the prognosis of fertility. The authors review their experience with the diagnosis and management of left varicocele in 20 pediatric patients 6 to 15 years old. All were managed under local anesthesia by spermatic venography and percutaneous transcatheter embolization of the internal spermatic vein with spring coils. All achieved satisfactory occlusion, and during the follow-up, from 13 years to 9 months, there was only one recurrence, noted in a patient 6 months after the procedure. Complications were phlebitis of the pampiniform plexus, leading to swelling and erythema of the left scrotum, and mild flank pain; these symptoms resolved without sequelae. This is a safe and effective nonsurgical method of obliterating varicoceles in children, with a low morbidity rate and a short hospital stay.
Asunto(s)
Embolización Terapéutica/instrumentación , Testículo/irrigación sanguínea , Varicocele/terapia , Niño , Estudios de Seguimiento , Humanos , Masculino , Radiografía , Recurrencia , Factores de Tiempo , Varicocele/diagnóstico por imagen , VenasRESUMEN
The value of computed tomography (CT) in determining the cause of obstructive jaundice in 67 proved cases is described. The presence of stones, the level of obstruction, the relative size of the ringlike structures produced by the dilated bile duct, and the shape of the distal visualized ring have proved to be the most important variables. The retrospective analysis determined the correct cause in 94% of the cases. CT fulfills all goals considered important in obstructive jaundice and eliminates the need for invasive procedures in many cases.
