Treatment of male varicoceles by transcatheter ethanolamine oleate 5% foam sclerotherapy

Objective
The authors report the experience with foam sclerotherapy with no additional coils, evaluating clinical success, patients’ satisfaction, and complications.
Patients and methods
The authors conducted a retrospective study of 71 patients with 76 varicoceles (mean age: 29.3 years; range: 13–60 years) who underwent foam sclerotherapy with ethanolamine oleate 5% (range: 2–12 ml) in an outpatient setting between October 2016 and September 2018. For the follow-up, interviews with the patients were conducted (mean follow-up time: 6.4 months, with SD: 5.17 months).
Results
The technical success rate was 84.2%. There was a 100% response rate to the patient interviews. Follow-up revealed a clinical success rate of 83.9% and a persistence or relapse rate of 16.1%. Of the patients, 85.9% were absolutely satisfied with the outcome. In 94.9% of cases, pain or discomfort resolution was reported, and in 97% of cases, aesthetic issues were no longer a problem. Of partners, 63.2% achieved pregnancy, and in 50% of patients with preprocedural testicular atrophy, catch-up growth was observed. One patient with pampiniform plexus phlebitis received inpatient treatment with no long-term damage recorded.
Conclusion
Ethanolamine oleate 5% foam varicocele sclerotherapy is a safe and effective procedure, with a high rate of patients’ satisfaction, clinical and technical success, and considerable catch-up growth and pregnancy achievement.