Alzhinbaev M., Kusymzhanov S., Kadirbekov N., Husainov T.,

Kabdoldin K., Toktabayanov B.

Scientific centre of urology, Republic Kazakhstan, Almaty

DIAGNOSIS AND ENDOVASCULAR THERAPEUTIC INTERFERENCE’S AT RELAPSES OF VARICOCELE

Introduction and objectives. The relapses of varicocele have place after traditional operations and observed from 10 to 25%. We have large experience diagnostic and endovascular treatment this patology.

Material and methods. Eighty seven patients with varicocele relapse at the age from 16 to 21 underwent examination and treatment with the help of ultrasonic dopplerography and roentgenendovascular phlebography. Clinical evaluation of ultrasonic dopplerography for determination of hemodynamic type at varicocele relapse and differentiated approach to the type of endovascular phlebography is given.

A new method of antegrade endovascular sclerotherapy allowing to implement occlusion of both internal and external venous collectors at varicocele is developed and evaluated.Analysis of patients is made and etiology and pathogenesis of varicocele relapse development and determined. On the basis of phlebographic examinations three kinds of varicocele relapses are determined: a) residual relapses, conditioned by technical errors of surgical interferences made before; b) true ones arising due to newly formed vessels in retroperitoneal space; c) false relapses connected with venous reflux over external testicular vein.

Results. Algorithm of consistent and differentiated approach to carrying out of diagnostic examination and therapeutic endovascular interference at varicocele relapses is developed.

Conclusions. Differentiated approach to selection to endovascular method of varicocele relapses treatment allowed to receive good results in 91,3 % of observations, satisfactory - in 6,8 % of observations and nonsatisfactory - in 1,7 % of observations.