الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
from January 2018 to December 2020, we conducted a prospective study comprising 71 patients who underwent endovascular treatement of their testicular varicocele using foam sclerotherapy patients were evaluated by full history taking, clinical examination with assessment of their testicular varicocele, laboratory investigation especially semen analysis focusing on sperm number, concentration, motility and abnormal forms and imaging investigations especially scrotal duplex scan and CTV if highly indicated.The following criteria were studied: age, clinical presentation with infertility history, testicular varicocele grade, associated lower limbs varicosities, recent semen analysis and scrotal duplex ultrasonography.The primary end points were pain relief if present either testicular or pelvic, improvement in semen analysis regarding count number and sperm motility, infertility treatement and pregnancy outcome and the secondary end points were reccurence rate comparebable to other traditional surgical methods, avoidance of testicular atrophy as a complication of varicocele and procedure related complications.The mean age of our study patients was 29.3 years (range; 18 - 60). Patients with left sided grade III testicular varicocele were the most prevalent in our study.We classify our patients included in the study according to their clinical presentation and their indications for operation as follow; infertility which includes 30 men out of 71 patients (42.3%), testicular pain and/or discomfort represented by 23 men of the 71(32.4%), testicular or inguinal swelling and palpable bag of worms were in the remaining group which involve 18 patients out of the 71(25.3%)Patients were followed up for 12 months using clinical examination, and duplex scanning with specific attention testicular plexus occlusion by foam versus recanalization or relapse. In addition, post-procedure semen analysis was recorded in each clinic visit every 3 months.Significant improvement in the clinical signs and symptoms of all patients could be demonstrated, as testicular varicocele in our patients were disappeared during the follow up period. Both scrotal DUS and semen analysis showed marked improvement during period of follow up.This study revealed an overall technical successful rate of 86.5 % and clinical success rate of 86.2 % with minor periprocedure complications as contrast allergy and periprocedural testicular pain which occurred in 8 cases only (12 %).In this study, 21 cases (29.5%) experienced complications from 71 patients. There was no mortality. Postsclerotherapy scrotal pain was noticed in eight patients (11.3%). A pampiniform plexus phlebitis was diagnosed in five patients (7%) who developed severe swelling with pain after sclerotherapy and received treatment for 10 days.There were no long-term complications, such as testes loss. Other postprocedural complications include four cases (5.6%) of temporary inguinal/scrotal swelling, four cases (5.6%) of temporary minimal groin hematoma, and two cases (2.8%) of temporary pain in the flanks.This study highlights the need to identify PVR and treat it, to reduce recurrence rates and reduce the need for subsequent interventions. This current series suggests that in males with varicose veins, there might also be a good reason to look for, and treat, PVR, although it is clearly less prevalent than in females.