By A. N. Dardenne, P. Bodart, P. J. Van Cangh (auth.), Claude C. Schulman M. D. (eds.)
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Extra info for Advances in Diagnostic Urology
In older ehildren and adults, an anesthetie is not neeessary. Results We have performed 21 spermatie phlebographies in 15 patients, six with bilateral and nine with unilateral nonpalpable undescended testes. Of the unilateral, five were left and four were right sided. Seven patients were under 7 years old and six were adults. We obtained four different radiographie patterns (Table 1). No eomplieations were observed. Pattern 1. In ten eases, eomplete or partial filling of the pampiniform-like plexus was aehieved.
Recent developments in interventive radiology have introduced a therapeutic side to the method. Material and Method We studied 150 patients, age ranging from 5 to 41 years (mean 24 years). Of these patients, 4% were studied for impalpable testis, 23% for painful syndrome related to a clinical varicocele, 7% for postoperative recurrence of varicocele, and 66% for infertility. Both spermatic veins are catheterized using the right femoral vein Seldinger technique. After catheterization of the left renal vein, via the inferior vena cava, the tip of a Cobra polyethylene catheter is introduced into the outlet of the left spermatic vein located on the inferior wall of the left renal vein.
Two 34 W. F. Hendry and C. H. Jones re cent, controlled trials have shown no difference in the pregnancy rates of infertile couples when the male partner had a varicocele, irrespective of whether it was ligated or not (Rodriguez-Rigau et al. 1978; Nilsson et al. 1979). It would be easy to conclude that varicocele never needs ligation in a subfertile man. This would be at variance with previously reported experience, and would deny the individual patient with an abnormal sperm count the chance of improvement in seminal characteristics that may occur following surgical correction, after which additional medical or other therapy can be given ifnecessary (see Fig.