Adolescent varicocele: Tauber antegrade sclerotherapy versus Palomo repair

Purpose: There is general agreement on treatment for varicocele in pediatri c patients. Randomized prospective studies have shown that anatomical and f unctional lesions may be corrected. Due to the impossibility of seminal exa mination patients with moderate to large varicocele or ipsilateral testicul ar hypertrophy, characterized by a change in testicular consistency or symp toms, should undergo surgical correction. The best therapeutic approach is still under discussion. Materials and Methods: At 2 centers 2 therapeutic approaches to varicocele treatment in pediatric patients were compared, namely the Palomo repair and antegrade sclerotherapy according to Tauber. The 89 patients from the same geographical area elected 1 procedure after an explanation. From the medic al records we retrospectively evaluated operative time, postoperative analg esics, postoperative fever onset, complications, convalescence, recurrence and postoperative hydrocele. Results: After Palomo repair in 45 patients there were 2 recurrences (4.4%) and 2 postoperative hydroceles (4.4%). Of 44 antegrade sclerotherapy cases I was converted to Palomo repair, there was no hydrocele formation and rec urrence developed in 2 (4.5%). Testicular atrophy was not observed in any p atient regardless of the method used. The cost of the procedure was lower i n the sclerotherapy group. Conclusions: These data suggest that the failure rate was similar in both g roups. The principal advantages of sclerotherapy are simplicity, decreased cost and lack of hydrocele formation.