Effect of Varicocele Catheter Guided Glue Embolization on Male Fertility
Abstract
Ahmed Ali Habib, Mohammed Shaker Ghazy, Waleed Mohammed Hetta, Wessam Sherin Shokry, Mohammed Abdel Naeem Sallam.
Background: Varicoceles; dilation of veins within the pampiniform plexus, are present in 15% of the general male population. It is also one of the most frequent causes of male-factor infertility, with a prevalence of 30%–40% among men presenting for primary infertility evaluation and up to 85% in secondary infertility.
Aim of work: The purpose of this study is to measure the success rate of the embolization technique in patients with clinical and radiological varicocele by U/S complaining of infertility.
Patients and Methods: A prospective interventional study including 21patients suspecting varicocele presented by testicular pain or infertility, the patients underwent Varicocele embolization under local anesthesia with digital subtraction, then follow up was done after 2 weeks, 3 months and 6 months. The study was conducted in the Radiology Department at Ain-Shams University Hospitals, the period was between January 2018 till the end of September 2019.
Results: The proÑedure done for the different ÑÉ‘teÉ¡ories of the pÉ‘tients in our study, 15 pÉ‘tient underwent Æ–eft ISV emÆ…oÆ–izÉ‘tion, 4 ÑÉ‘ses underwent Æ…iÆ–É‘terÉ‘Æ– ISV, in one pÉ‘tient we emÆ…oÆ–ized riÉ¡ht ISV, É‘nd fÉ‘iÆ–ed É‘t one ÑÉ‘se to ÑÉ‘thetrize ISV.
The study showed that there was statistically significant increase in number and motility of the studied cases with p-value = 0.030 and 0.002 respectively on follow up. 47.6 % of our patients underwent minor complications with 23.8 % of them underwent post procedural pain, 9.5 % ISV peroferation, 4.7 % underwent extravasation and we failed to catherterize the ISV in 4.7 % of the cases.
Conclusion: Gonadal Vein Embolization is an effective way in treating varicocele, with our study showing significant improve as regard sperm count /ml with significant decrease in the patient in comparison to pre and post procedural data, with highly significant improve of sperm motility in 3 months follow up.