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Roentgenoendovascular study of children with varicocele


, : Roentgenoendovascular study of children with varicocele. Urologiya i Nefrologiya (1): 57-61

60 patients with varicocele first diagnosed and 38 with postoperative recurrences of varicocele were examined with the use of digitalis subtraction renal and testicular phlebography as an optional diagnostic method. In the patients' group with varicocele recurrences the roentgenoendovascular method allowed the causes of relapses associated with inadequate ligation of testicular vein influxes to be revealed (73.3%) and collateralization of the operated region (26.3%). In patients with firstly diagnosed varicocele the phlebography confirmed the diagnosis in 98.3%; revealed associated urogenital diseases; allowed indications for a specific mode of surgical correction to be formulated. 78 patients underwent testicular vein roentgenoendovascular occlusion with 3% solution of thrombovar, 15 were operated on by the method of Ivanisevich in whom a level and character of surgical ligation were defined by phlebographic data; one patient had the operation testiculosaphenous anastomosis; one patient was not operated due to his systemic blood disease. By digitalis subtraction angiographic data recurrence rates after a proper treatment were 2%. 4.1% had thrombophlebitis of the racemose plexus after a sclerotherapy conservatively abolished. The use of digitalis subtraction testiculophlebography allowed one to properly choose a surgery and to decrease relapse rates due to its high preoperative diagnostic efficacy. In addition, preoperative X-ray endovascular examination made it possible to reveal the cause of relapses after early performed operations, to detect synchronous renal lesions in time, and to prevent recurrences by reducing the amount of a contrast medium by a factor of 2.3.

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