Antegrade scrotal phlebography of the spermatic vein in case of left-sided varicocele of the testis - Are retrograde phlebography classifications suitable for typifying?

Purpose: The study was conducted to clarify whether the use of classifications in base of retrograde phlebography would be sufficiently suitable for typifying the findings of antegrade phlebography examinations of the internal spermatic vein with regard to antegrade sclerotherapy. Subjects and methods: In course of antegrade sclerotherapy in 236 patients with previously untreated idiopathic left-sided varicocele, phlebography via scrotal approach was performed. The results were compared with the relevant findings of the pre-existing classifications of the retrograde exams. Results: Comparison with the classifications of Bahren and Braedel showed distinct discrepancies. In 28.8% (Bahren) respectively 36.45% (Braedel) of our findings, typification was unsuccessful. Correspondence was found with the Riedl-classification. Collateral vessels however, are not sufficiently differentiated. Conclusion: Retrograde classifications proved insufficient in typifying the findings of antegrade phlebography of the internal spermatic vein. A more subtle classification is required. This has been worked out and presented.