Jm. Bigot et al., ANASTOMOSES BETWEEN THE SPERMATIC AND VISCERAL VEINS - A RETROSPECTIVE STUDY OF 500 CONSECUTIVE PATIENTS, Abdominal imaging, 22(2), 1997, pp. 226-232
Citations number
21
Categorie Soggetti
Gastroenterology & Hepatology","Radiology,Nuclear Medicine & Medical Imaging
Background: Do visceral-spermatic vein shunts have any clinical impact
on sclerotherapy of varicoceles? Methods: The spermatic venograms of
500 consecutive patients were retrospectively reviewed to classify vis
ceral-spermatic communications. Men with an average age of 27.8 years
(range 11-65 years old) underwent sclerotherapy of a varicocele. Of th
e 500 men, 445 were referred for oligoasthenospermia (89%), 45 for pai
n (9%), and 10 for prevention of infertility (2%). After bilateral cat
heterization, percutaneous sclerosis was performed below the upper thi
rd of the sacroiliac joint. Results. Three hundred forty patients (68%
) had left-sided, 10 (2%) had right-sided, and 150 (30%) had bilateral
varicoceles. Left side: Of 46 (9.4%) anastomoses, one (0.2%) communic
ated with the splenic vein and 45 (9.2%) with the inferior mesenteric
vein of which 25 (5.1%) were a colic trunk with a competent valve, 15
(3.1%) were venules, and five (1%) were a single or double anastomosis
. Right side: Of 48 (29.6%) anastomoses to the superior mesenteric vei
n, 34 (21%) were venules, 12 (7.4%) were a colic trunk with a competen
t valve, and two (1.2%) were a single or double vein. Our varicocele r
ecurrence rate was only 1.2%. Conclusion. Visceral-spermatic vein comm
unications are classified by number, morphology, and site. Percutaneou
s sclerotherapy could be optimized when performed caudally to these co
mmunications.