The role of spermatic venography after surgical high ligation of the left spermatic veins: diagnosis and percutaneous occlusion.

Bilateral spermatic venography was performed in 40 patients who had previously undergone surgical high ligation of the left spermatic vein. Indications included recurrent or persistent varicocele or oligoteratospermia syndrome. Despite the prior surgery, 21 patients had venographic demonstration of a left-sided varicocele. Right-sided varicocele was demonstrated in 19 patients, 9 of whom also had left varicoceles. Only 9 patients did not have a varicocele demonstrated on either side. The various mechanisms of varicocele filling are discussed. Whenever a varicocele was demonstrated, immediate occlusion using steel coils was performed.

Percutaneous venography and occlusion in the management of spermatic varicoceles.

Spermatic venography was performed in 140 patients; the main indications were subfertility and abnormal spermatogenesis. Of these 140 patients, 113 had positive examinations, with 33 of them having bilateral varicoceles. Of 146 total varicoceles demonstrated, 42 were found on the right side; the advantage of using the jugular vein approach in both the diagnosis and percutaneous treatment of these cases is stressed. Of the 146 varicoceles, 128 were successfully occluded using spring coils. Because of the frequency of bilateral subclinical varicoceles, spermatic venography and percutaneous embolization is recommended in all men with subfertility and oligoteratoasthenospermia.