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PS-067 Treatment Of Varicocele In Paediatric Patients With Contraindication For Open Surgery With Transfemoral Retrograde Sclero-embolization Under Local Anaesthesia
  1. N Zampieri1,
  2. RL Castellani2,
  3. G Zampieri2,
  4. FS Camoglio1
  1. 1Department of Surgical Sciences Pediatric Surgical Unit University of Verona Policlinico G. B. Rossi Piazzale L. A. Scuro N.1 37134 Verona Italy, University of Verona, Verona, Italy
  2. 2Department of Surgery, CASA Di Cura San Francesco, Verona, Italy

Abstract

Background Varicocele treatment in paediatric age is still under discussion, the aim of this study is to present our experience with transfemoral retrograde sclero-embolization in paediatric patients and varicocele under local anaesthesia with contraindication for open surgery.

Materials and methods Between December 2008 and December 2012 184 patients 10 to 14 years of age with left varicocele were treated. Study inclusion criteria were created: grade II or III left varicocele; previous inguinal surgeries and contraindications to general anaesthesia. Sclero-embolization included the following procedures: right femoral access under local sedation (carbocaine). Mean time of intervention, recurrence and persistence rates as well as early and late complications were also considered.

Results During the study period 184 cases were treated with the radiological technique, 172 of which proved to be successful. In 10 cases a continent valve was found and it was therefore impossible to use this technique (5,4%); Two cases had rupture of the vein with consequent spillage of the contrast agent. Twelve cases (6,5%) showed recurrence No patient reported postoperative pain.

Discussion This technique proved to be efficient and reliable. It can be performed under local sedation and it involves fewer complications than traditional techniques.

The use of such technique allows preservation of the spermatic artery and is free from complications like testicular atrophy and hydrocele.

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