Four years' follow-up results of three different percutaneous treatments for male varicocele

Objective: To evaluate the efficacy of three different interventional radiological procedures for the treatment of venous reflux in symptomatic male varicocele. Design: Prospective study with a 48-month colour duplex ultrasound (CD) follow-up. Setting: Department of Radiology, Tor Vergata University of Pome. Patients: From January 1991 to December 1993, 45 symptomatic patients with third- to fourth-degree varicocele, according to Sarteschi's CD classification, were randomly divided into three equal groups (15 patients each). Interventions: The first group received sclerotherapy (Athoxysclerol), the second underwent embolisation (Gianturco coils), while the third group received combined sclero-embolisation therapy (Athoxysclerol and Gianturco coils). Main outcomes measures: The frequency of recurrence for each procedure. Results: Two recurrences (13%) after 1 and 2 years occurred in patients who underwent sclerotherapy. In the embolisation group, two patients showed residual varices (13%). Neither recurrence nor-residue was seen in the third group, who received combined therapy. Conclusions: Sclerotherapy provides good immediate results but drug dilution may cause a relapse shortly after treatment. Embolisation has a lower immediate success but better long-term success. Combined treatment provides the highest long-term success-rate.