Transcatheter foam sclerotherapy of symptomatic female varicocele with sodium-tetradecyl-sulfate foam

to evaluate the efficacy of transcatheter foam sclerotherapy (TCFS) in pelvic varicocele using sodiumtetradecyl-sulfate foam (STSF), we conducted a retrospective study in 38 patients (mean age, 36.9 years; range, 22–44 years) with pelvic congestion syndrome (PCS) treated between January 2000 and June 2005 by TCFS. pelvic pain was associated with dyspareunia in 23 (60.5%) patients, urinary urgency in 9 (23.7%) patients, and worsening of pain during menstruation and at the end of a day of work in 7 (18.4%) and 38 (100%) patients, respectively. diagnosis was made by pelvic and transvaginal color doppler ultrasound examination, demonstrating ovarian or pelvic varices with a diameter [5 mm presenting venous reflux. TCFS was performed in all patients, using 3% STSF. follow-up was performed by physical examination, pelvic and transvaginal doppler ultrasound examination and by a questionnaire-based assessment of pain at 1, 3, 6, and 12 months after the procedure. technical success was achieved in all patients (100%). In three patients a pelvic colic-like pain occurred immediately after sclerotic agent injection, disappearing spontaneously after a few minutes. no recurrent varicoceles were observed during a 12-month follow-up. a statistically significant improvement in each category of specific symptoms was observed at 1, 3, 6, and 12 months after the procedure. we conclude that TCFS of female varicocele using a 3% STSF is safe and effective for the treatment of PCS. It is associated with a significant reduction of symptoms and can be regarded as a valid alternative to other endovascular and surgical techniques.