Simultaneous microsurgical spermatic vein ligation and sclerotherapy - A combined procedure for the treatment of recurrent or persistent varicocele

Objectives: Microsurgical ligation as well as antegrade sclerotherapy have been established in varicocele treatment. The aim of this study was to eval uate whether a combination of microsurgery. and sclerotherapy can: provide a safe and effective treatment of varicocele recurrence or persistence. Methods. Nine patients with, recurrent or persistent varicoceles were opera ted by means of the combination method. Under microscopic control varix vei ns were ligated selectively preserving: lymphatics and arteries. Ectopic ve ins as a possible source for varicocele persistence or recurrence were also ligated. Finally, an intraoperative venography with subsequent sclerothera py was, performed through one of the dissected veins. Results. Despite: difficult anatomical situations after previous surgical i nterventions, the operations were perform, ed successfully without any comp lications. Clinical controls showed varicocele disappearance without damage of the testis. No varicocele recurrence or persistence was observed. Conclusions. This method combines the advantages of both methods. Precision of the microsurgical technique is combined with velocity of sclerotherapy. Thus, it may represent an Interesting alternative to conventional operatio n methods especially in the treatment of recurrent or persistent varicocele s. Copyright (C) 2001 S. Karger AG, Basel.