[Percutaneous sclerotherapy as primary treatment of testicular insufficiency in idiopathic varicocele].

Among 1217 percutaneous retrograde phlebographies of the left renal/testicular vein 1069 were performed for primary treatment of left-sided idiopathic varicocele. In 989 of these patients (92.5%) an insufficient testicular (internal spermatic) vein with reflux to the pampiniform plexus could be shown phlebographically, in 802 cases percutaneous sclerotherapy could be performed. This amounts 75.0% of patients with varicocele or 81.1% of the cases with a phlebographically proven testicular vein insufficiency. In this group percutaneous sclerotherapy has proven to be a safe and effective treatment of idiopathic varicocele on an outpatient basis and has replaced surgical ligation as method of choice. However, with anatomical and technical obstacles to sclerotherapy, especially in patients with varicocele but without phlebographic evidence of an insufficient testicular vein, surgery remains an essential means of therapy.