Outcomes of percutaneous coil embolization of gonadal vein for management of varicocele. Experience at tertiary care hospital of Pakistan

Syed Muhammad Faiq; Khair Muhammad; Waseem Mirza; Ameet Jesrani

Abstract
Objective: To study the role of angiographic endovascular coil embolization as a treatment of varicocele in adults presenting with clinical and sonographic diagnosis.
Methodology: This descriptive study was conducted at radiology department of Sindh Institute of Urology and Transplantation (SIUT) Karachi from May 2010 to March 2021. Fifty patients initially seen by an experienced urologist, with complains of dull pain in testes and swelling in scrotum after prolong standing and having “bag of worms” like presentation on physical examination and graded moderate to severe varicocele participated in the study. They had color doppler ultrasound to make the sonographic diagnosis and determine the grade of the disease and later were scheduled for angiographic percutaneous coil embolization of varicocele. Data regarding success rate and failure rate along with clinical aspects were analyzed.
Results: Endovascular embolization of the gonadal vein was successful in 94% of cases. Six-month post procedure follows up showed sign and symptom control in 42 out of 50 patients making success rate of 94%. There was failure of procedure in three cases due to access through internal jugular vein and congenital variation of venous anatomy.
Conclusion: Endovascular coil embolization was a better approach for treatment of varicocele in comparison to surgery.

Key words: Percutaneous, coil, embolization, gonadal vein, varicocele.

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