Percutaneous puncture catheter-directed foam sclerotherapy of ovarian varicocele: report of preliminary results

Abstract

Foam sclerotherapy of ovarian varicocele is a relatively new and promising treatment option for patients with axial reflux. But its usefulness may be limited by low primary occlusion rates. Here a standard technique for catheter-directed foam sclerotherapy was presented to facilitate a precise delivery of foam to its intended site of action so as to potentially improve the occlusion rates. A selective series of 13 females with ovarian varicocele were treated with foam sclerotherapy through a standard technique for foam delivery from 2008 to 2009. With a mean age 39.4 years, the patients were treated with 1% polidocanol foam through a catheter inserted percutaneously over a guidewire into the trunk of vena ovarian. All successfully treated patients were examined by colour duplex at 1 to 12 months post-procedure. Thirteen patients with an insufficiency reflux of vena ovarian were treated with catheter-directed foam sclerotherapy. Primary technical success was achieved in all patients. A dose of polidocanol 1.0% at 4 - 9 ml was administered. The mean follow-up period was 5.3 months. Pelvic cavity flatulency was totally released in 12 patients and 1 partially released. Two of 5 patients with algopareunia recovered and 3 with perineal region varicosis became relieved. On the follow-up ultrasonic examination, all trunks of vena ovarian became occluded. This type of foam sclerotherapy is feasible with a high rate of primary occlusion.