Nationwide Children's Hospital, Department of Urology, 700 Children's Drive, G280, Timken Hall, Columbus, OH 43205, USA.
J Pediatr Urol. 2010 Dec;6(6):567-71. doi: 10.1016/j.jpurol.2010.01.003. Epub 2010 Feb 11.
Postoperative hydrocele development is a frustrating complication of varicocele surgical repair. To avoid this complication, we began to offer percutaneous embolization as a treatment option. We present our initial experience with this technique.
A retrospective review of all patients who underwent percutaneous embolization and sclerotherapy of a varicocele at our institution was performed.
There were 27 patients with a mean age of 16 years (range 13-19 years). Indications included pain (48%), varicocele size (30%) and persistent testicular asymmetry (22%). Four patients had experienced failure of a previous surgical repair. Follow-up data were available for 21 patients (mean 9 months). The varicocele resolved in 19 patients (91%) with no evidence of hydrocele formation in any of the boys. There was resolution of pain in all patients for whom this was the indication for the procedure. In the two failures, access to the lower spermatic vein was not possible owing to the number and tortuosity of the vessels.
Percutaneous embolization and sclerotherapy represent a truly minimally invasive treatment with low morbidity, minimal pain and rapid recovery. In our early experience, since lymphatic channels are completely avoided, there appears to be no risk of hydrocele formation.
精索静脉曲张手术后出现鞘膜积水是一种令人沮丧的并发症。为避免这种并发症，我们开始将经皮栓塞作为一种治疗选择。我们介绍了这种技术的初步经验。
对在我们机构接受经皮栓塞和硬化治疗精索静脉曲张的所有患者进行了回顾性分析。
共有 27 例患者，平均年龄 16 岁（范围 13-19 岁）。适应证包括疼痛（48%）、精索静脉曲张大小（30%）和持续的睾丸不对称（22%）。4 例患者曾经历过先前手术修复的失败。21 例患者（平均 9 个月）获得了随访数据。19 例患者（91%）的精索静脉曲张得到了缓解，没有任何男孩出现鞘膜积水的证据。对于所有因疼痛而接受该手术的患者，疼痛均得到缓解。在两次失败中，由于血管数量和迂曲，无法进入较低的精索静脉。
经皮栓塞和硬化治疗是一种真正微创的治疗方法，具有低发病率、最小的疼痛和快速的恢复。根据我们的早期经验，由于完全避免了淋巴管，似乎没有形成鞘膜积水的风险。
