Varicoceles are abnormally dilated pampiniform plexus veins. They may present with pain or can be discovered during investigations of infertility. The relationship between varicoceles and infertility remains controversial. Varicoceles may be treated surgically or by embolization.
Venous embolization of the internal spermatic vein is a safe and effective minimally invasive method to occlude the varicocele. Embolization can be enhanced by the additional use of a sclerosant, such as sodium tetradecyl sulfate (STS) foam. Multiple embolic and sclerotic agents can be used when treated under image guidance, and each agent has its own advantages and disadvantages. Surgical and interventional outcomes are similar in unilateral left-sided varicoceles, with embolization usually having a shorter hospital stay and a lower chance of hydrocele formation. Surgery may be advantageous in bilateral varicoceles.
Collaboration between the urologist and the interventional radiologist as well as using standard classifications and nomenclature facilitates patient care and treatment.
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