Endovenous laser ablation of spermatic vein for the treatment of varicocele

Introduction:Varicocele is a relatively complex pathology of the scrotum veins', known to be one of the easiest totreat. Modern treatment involves both surgical (open, laparoscopic and microsurgery) and interventional ap-proach (either with coils and/or sclerosant injection). Our aim is to demonstrate the feasibility and the reliabilityof endovenous laser ablation (EVLA) of the spermatic vein for the treatment of varicocele.Materials and methods:We consecutively and prospectively treated 11 patients (age range 24–45 years old, mean31y) with left varicocele, phlebografically classified as Bahren type I and with indication for percutaneoustreatment. Clinical success was evaluated by color doppler ultrasound (CDUS) one week, one months and threemonths after the procedures. We also evaluated the pain feeling for 48 h after the procedure on the basis of thevisual analogue score (VAS) obtained through telephonic interview.Results:Technical success was achieved in all cases. In all cases varicocele disappeared at CDUS at 1 and threemonths with reflux abolition. Two cases of small vein laceration were noted without sequelae, no other com-plication has been described. All patients reported improvements either regarding symptoms and/or spermio-graphic parameters.Conclusions:In our experience, EVLA of spermatic vein is a feasible and safe treatment in patients with Bahrentype I varicocele. The key advantage of this technique is the adoption of a standardized protocol, which remainsone of the main problems in gaining scientific evidence in case of coil or sclerosant embolisation (type andnumber of coils, amount of sclerosant agent etc)