Use of an alcohol sclerosing agent is effective in 98% of men and does not require hospitalization.

SEATTLE—Non-surgical transcatheter retrograde sclerotherapy of male varicocele is highly effective and enables more rapid recovery than surgery, researchers reported here at the Society of Interventional Radiology annual meeting.

The non-surgical approach resulted in consistent improvement in sperm counts, motility, structure, and form following endovascular treatment, according to investigators

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“This interventional radiology procedure does not require hospitalization or general anesthesia, results are comparable to or better than surgery, and the recurrence rate is lower,” said study author Maurizio Grosso, MD, an interventional radiologist at Santa Croce e Carle Hospital in Cuneo, Italy. “Hopefully, this research will make American men more aware of their treatment options.”

All the men were treated with trans-catheter injection of a liquid alcohol (hydroxypolyethoxydocanol) as a sclerosing agent to close off the internal spermatic vein in order to improve sperm parameters and male fertility and alleviating the symptoms, Dr. Grosso said. After the outpatient procedure, each man stayed six hours at the hospital before being discharged. A major benefit of embolization, Dr. Grosso said, is that patients require only an average of one or two days to recover completely and they may then resume physical activity. Surgery usually has a 14- to 21-day recovery time, and patients need another two to three weeks before they return to physical activity.

The study, done over seven years, included 940 procedures on 925 patients with a mean age of 29.2 years. Of the 925 men, 467 (50.5%) had varicocele III, 440 (47.6%) had varicocele II, and 18 (1.9%) had varicocele I. Complete resolution was achieved with just one procedure in 910 out of 925 patients (98.4%). Of the remaining 15 patients, 12 had complete resolution with a repeat procedure and three had relapses but did not undergo retreatment. No major complications requiring discontinuation of the intervention or hospitalization occurred.

Dr. Grosso said this study con-firms the cost-savings and feasibility of this technique. Among the findings: minimally invasive treatment, less pain, less risk, no hospitalizations, no operating costs, no general/epidural anesthesia. Recurrence rates were extremely low and, if they did occur, patients could be safely re-treated, Dr. Grosso said.