Antegrade Scrotal Sclerotherapy of Internal Spermatic Veins for Varicocele Treatment: Results and Complications about 660 Cases
Introduction: Varicocele is one of the leading causes of male infertility. Anterograde scrotal sclerotherapy (ASS) is one of the most recent techniques. Our objective is to evaluate the results of ASS in the treatment of varicocele in adults. Methods: This is a descriptive and analytical study of 660 patients treated for varicocele causing either a picture of hypofertility and/or symptomatic during the period from January 2008 to December 2018. Preoperative, intraoperative and postoperative data were analysed. Results: The average age was 30. The average duration of the intervention was 16 minutes (13-50 mins) and the average length of hospitalization was 19 hours (9-36 hours). We noticed a statistically significant improvement in all characteristics on the postoperative spermogram. Oligospermia increased from 41% to 29% (p=0.01), asthenospermia increased from 52% to 33% (p=0.02) and teretospermia from 24% to 14% (p=0.006). The paternity rate among hypofertile men was 22%. The disappearance of varicocele in postoperative was objectified in 588 patients (84%), the disappearance of scrotal pain in 322 patients (48%). Complications were identified in 70 patients (10.6%) hydrocele (27 patients, 4%), scrotal hematoma (14 patients), chemical orchitis (20 patients) and testicular atrophy (9 patients). A recurrence was noted in 73 patients (11%) at 9 months. Conclusion: SSA appears to be a reliable and reproducible technique in the treatment of varicocele, with significantly less morbidity in comparison with other techniques. We recommend it as a first-line treatment.