325 Antegrade Sclerotherapy: A Viable Option for the Treatment of Varicocele in the United Kingdom? a Single Centre Perspective

Abstract

Abstract Aim Antegrade sclerotherapy has been used for the treatment of varicoceles since the 1970s. Despite its efficacy, minimally invasive technique, and short learning curve it is not routinely used in the United Kingdom. With the prospect of an increase in varicocele operations, with the European and American Associations of Urology now advocating for treatment in sub-fertile men with clinical varicoceles, we aim to look at the experiences of this procedure in a UK urology unit. Method A retrospective review of antegrade sclerotherapy for varicoceles within a single centre in North Wales. The primary outcome being clinical recurrence and secondary outcomes of fertility and radiation exposure. Results 37 patients with a median age of 28 (range 14-65) were included. 35 out of 37 patients had a reported pre-operative scrotal ultrasound showing a left sided varicocele. The most common indication for procedure was pain (70.3%) followed by subfertility (21.6%). 45.9% were exposed to only 1 shot of radiation during the procedure. The median follow up was 3 months and only 2 patients had clinical recurrence and there were no significant complications (Clavien-Dindo > 3). 3 of 8 patients with subfertility had successful paternity. Another 4 patients had semen analysis, all of them had improved sperm count, motility, morphology postoperatively. Conclusions Antegrade sclerotherapy shows favourable outcome of only 5.4% recurrence accompanied with low dose of radiation. 37.5% of sub fertile patient managed to achieve paternity. This is another viable treatment option for consideration in the treatment of varicoceles.