Should Varicocele Be Managed Surgically or Radiographically? (Radiology)

  • Luke E. Sewall
  • Steven Janney Smith


Varicoceles are relatively common in the male population; however, in a minority of patients, they can cause pain or infertility. Since the original recognition of varicoceles as a pathologic process, many different surgical techniques and percutaneous options have been developed. Percutaneous embolization options have evolved significantly over the years from the original occlusion balloon to bare stainless steel coils to fibered platinum coils to a variety of liquid embolic agents. These agents include sodium tetradecyl sulfate, N-butyl cyanoacrylate, and others. In addition, the tools to navigate the venous system have also improved with the development of microcatheters and guidewires, which can now easily negotiate even very tortuous internal spermatic vein and renal vein anatomy, as well as collateral or aberrant pathways that will occasionally lead to reflux. This improvement in both equipment and embolic agents has led to a progressive improvement in the technical success rate of trans-catheter therapy and a decline in recurrence rate. This improvement, combined with the negligible complication rate, makes varicocele embolization the optimal treatment option for symptomatic varicoceles.


Embolization Sclerotherapy Sotradecol Fibered coils N-Butyl cyanoacrylate Recurrence rate Trans-catheter therapy Gonadal vein Internal spermatic vein Male varicocele Technical success rate 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Luke E. Sewall
    • 1
  • Steven Janney Smith
    • 1
  1. 1.Department of Interventional RadiologyVascular and Interventional ProfessionalsHinsdaleUSA

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