Treatment of varicocele with transferal retrograde sclero-embolization in pediatric patients under local anesthesia

Aim. Varicocele treatment in pediatric age is still under discussion. The aim of this study was to present our experience with trans-femoral retrograde sclero-embolization in pediatric patients and varicocele under local anesthesiaMethods. Between December 2008 and De-cember 2011, 184 patients aged between 10 to 14 years with left varicocele were treated. Study inclusion criteria were: grade II or III left varicocele; previous inguinal surgeries and contraindications to general anesthesia. Scle-ro-embolization included the following proce-dures: right femoral access under local seda-tion (carbocaine). Mean time of intervention, recurrence and persistence rates as well as ear-ly 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 after 3 months. No patient reported postoperative pain.Conclusion. This technique proved to be effi-cient and reliable. It can be performed under local sedation and it involves fewer compli-cations than traditional techniques. The use of such technique allows preservation of the spermatic artery and is free from complica-tions like testicular atrophy and hydrocele.