Journal of Ultrasound in Medicine, Vol 13, Issue 12 953-958, Copyright © 1994 by American Institute of Ultrasound in Medicine
Doppler sonography of varicocele: long-term follow-up after venography and transcatheter sclerotherapy
F. W. Winkelbauer, M. E. Ammann, F. Karnel and J. Lammer
Department of Radiology, University of Vienna, Austria.
Sixty-eight patients with unilateral left-sided idiopathic varicocele who
had not been treated previously were examined with Doppler sonography
before and 1, 3, and 12 months after selective venography with balloon
occlusion and transcatheter sclerotherapy of the internal spermatic vein.
Varicocele and its persistence or recurrence was diagnosed by reflux only.
Reflux was differentiated into stop-type and shunt-type by Doppler
sonography. The resolution of varicocele was defined by absence of any
reflux. The rate of resolution was greatest 3 months after sclerotherapy
(49 patients, 72%). The diagnosis of persisting or recurring varicocele at
this time does not seem to be justified, however, as in our study both
further improvement and deterioration were observed up to 12 months after
treatment. Twenty patients (29%) had a persisting or recurring varicocele
12 months after sclerotherapy. Reflux is the parameter of significance for
diagnosing varicocele and its persistence or recurrence after therapy.
Improvement of clinical aspects of varicocele (e.g., sperm count, sperm
motility, and conception rates) depends on therapy of even subclinical
varicoceles. Therefore, diagnosis and retreatment of persistent or
recurrent varicoceles seems essential. The high sensitivity of Doppler
sonography permits adequate assessment of the therapeutic result and
evaluation of real rates of persistent or recurrent varicoceles after
venography with balloon occlusion and transcatheter sclerotherapy.
