Antegrade Sclerotherapy Research Articles

Semen analysis after treatment of varicocele by antegrade scrotal sclerotherapy.

Varicocele is a major cause of male infertility. Different studies have shown that varicocele is associated with a progredient deterioration of testicular function. This fact constitutes the indication for treatment of varicocele, which has been underscored by the results of studies demonstrating that the correction of varicocele can arrest testicular damage and can lead to improved spermiogenesis (Hadziselimovic et al., 1989; Kass & Belman et al., 1987). We have established antegrade scrotal sclerotherapy (ASS) for treatment of varicocele (Tauber & Johnsen, 1994). This study wants to examine the influence of antegrade sclerotherapy of varicocele on spermiogenesis and generative power.

Vascular organization of the pampiniformis plexus in the man and its significance for antegrade sclerosing of testicular varicocele

The vascular organization of human spermatic cord was analyzed by means of injection and by casting preparation of the testicular artery and veins of the pampiniform plexus after orchiectomy. After leaving the human testis, the testicular veins are organized in two main groups and form two vein plexus. One of these vein groups forms a tight plexus around the testicular artery. Computer-aided 3-D reconstructions based on the paraffin serial sections of the human spermatic cord allowed us to demonstrate the relation between the blood vessels and the other tissue structures of the spermatic cord. The results obtained allowed us to subdivide the human spermatic cord into three compartments. The dorsomedial compartment contains the vas deferens and its blood vessels. The middle compartment contains the testicular artery and the vein group which forms a tight plexus around this artery. The ventrolateral compartment contains a vein group which shows no topographic relation to the testicular artery. This vein group is embedded in a large, macroscopically visible volume of fatty tissue. To be sure of sparing the testicular artery during antegrade sclerotherapy this vein group should be prepared.

Antegrade Scrotal Sclerotherapy for the Treatment of Varicocele: Technique and Late Results

Antegrade sclerotherapy has been used since 1987 to treat patients with variocele. The method has proved to be easy to perform, safe, economical and effective. The treatment results in 285 patients who had undergone sclerotherapy for a total of 317 varicoceles are presented and discussed. This followup study revealed that 285 of the patients (91%) had no signs of recurrent or persistent varicocele. In 57 cases (42%) of inability to conceive the partners became pregnant after antegrade varicocele sclerotherapy. Antegrade sclerotherapy represents an alternative treatment to high ligation and retrograde sclerotherapy, as well as to laparoscopic and microsurgical procedures.