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Division of Pediatric Surgery, San Carlos University Hospital, Madrid, Spain.
The treatment of varicocele is controversial in boys and it is a contributing factor to male infertility. Recently it has been proposed that early therapy of a varicocele during childhood or adolescence may improve the prognosis of fertility. The authors review their experience with the diagnosis and management of left varicocele in 20 pediatric patients 6 to 15 years old. All were managed under local anesthesia by spermatic venography and percutaneous transcatheter embolization of the internal spermatic vein with spring coils. All achieved satisfactory occlusion, and during the follow-up, from 13 years to 9 months, there was only one recurrence, noted in a patient 6 months after the procedure. Complications were phlebitis of the pampiniform plexus, leading to swelling and erythema of the left scrotum, and mild flank pain; these symptoms resolved without sequelae. This is a safe and effective nonsurgical method of obliterating varicoceles in children, with a low morbidity rate and a short hospital stay.
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