Comparison of early deflation rate of detachable latex and silicone balloons and observations on persistent varicocele.

PURPOSE

To determine the frequency of and time until spontaneous deflation of detachable embolization balloons made of different materials and the correlation between persisting or recurrent varicocele and the spontaneous deflation of the balloons.

MATERIALS AND METHODS

Forty-five patients with clinically detected left-sided varicocele underwent embolization with 78 silicone and 22 latex balloons. The minimum follow-up time was 3 months and the follow-up consisted of clinical examination, color duplex ultrasonography, and plain radiography of the balloons. Those patients who were suspected of having recurrent varicoceles underwent control venography to assess the internal spermatic vein.

RESULTS

All of the latex balloons and 10% of the silicone balloons deflated spontaneously during the follow-up. The average time until deflation was 5.1 months for latex and 9.9 months for silicone balloons. Persistence of varicocele, attributed to perfusion through a previously occluded portion of the internal spermatic vein, occurred in two of 11 (18%) recurrences. Nine of 11 (72%) recurrences were due to bypassing collaterals past the site of detachable balloon placement.

CONCLUSIONS

Latex balloons seem to predispose more to persisting/recurrent varicocele than silicone balloons. Early deflation of the balloons explained two (18%) of the 11 persisting or recurrent varicoceles. A combination of a sclerosing agent with balloon embolization of the internal spermatic vein is recommended.