Varicocele embolization with polidokanol and coil

Case contributed by Dr Maciej Mazgaj

Presentation

Infertile young male with abnormal semen test results. Sonographically proven left varicocele with testicular volume loss.

Patient Data

Age: 20 years
Gender: Male

The catheter is placed in the proximal part of the testicular vein (route: iliac vein, IVC, left renal vein). After confirming the existence of varicocele, sclerosing agent and embolizing coil(s) are used. Control study shows successful embolization of testicular vein.

Venogram image 1: left renal venogram showing the left testicular vein

Venogram image 2: retrograde opacification of pampiniform plexus as a proof of insufficient valves resulting in varicocele. Series revealed existing collaterals of testicular vein.

Venogram image 3: series after administering embolizing agent. Partial occlusion of testicular vein lumen visible.

Venogram image 4: series after administering additional embolizing coil. No flow within testicular vein visible.

Case Discussion

Patient with chronic left groin and scrotal pain. Recent semen analysis showed immobile spermatozoa. Ultrasound examination revealed left varicocele. Intravenous left testicular vein embolization was performed to occlude veins draining the varices.

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