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 pro�edure done for the different �ɑteɡories of the pɑtients in our study, 15 pɑtient underwent Ɩeft ISV emƅoƖizɑtion, 4 �ɑses underwent ƅiƖɑterɑƖ ISV, in one pɑtient we emƅoƖized riɡht ISV, ɑnd fɑiƖed ɑt one �ɑse to �ɑthetrize 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.