Tauber's antegrade sclerotherapy for the treatment of varicocele in children and adolescents. Does the pubertal stage matter?

Purpose: To compare the results of Tauber's antegrade sclerotherapy at different pubertal stages and, notably, to evaluate its feasibility in pre-pubertal age.

Methods: We retrospectively reviewed the clinical records of patients that underwent antegrade sclerotherapy at our centre between 2005 and 2019. We divided our population into groups based on pubertal stage according to Tanner's classification. Pre-operative, intra-operative and post-operative data were collected. Finally, we assessed the association between Tanner's stage at surgery, operative characteristics, short-term complications and long-term outcomes.

Results: 513 patients were included in our study. Median age was 13 years (range 9-17). 467 (91%) underwent the procedure under local anaesthesia or with mild sedation. Median operative time was 23 min. In 7 cases (1%) conversion was necessary due to intraoperative complications. In 31 cases (6%) we observed minor post-operative complications. Recurrence rate was 3%. Data analyses revealed that there were statistically significant differences among different Tanner's pubertal stages at the intervention in terms of type of anaesthesia (p = 0.009). No difference was found in terms of operative time (p = 0.214), conversion's rate (p = 0.406), postoperative complications (p = 0.159), and clinical outcomes at 1 month (p = 0.916), 6 month (p = 0.112) and at final follow up (p = 0.312).

Conclusion: Tauber's antegrade sclerotherapy is a reliable technique in the treatment of paediatric and adolescent varicocele, regardless of patients' pubertal stage. Although prepubertal patients may need more general anaesthesia, the procedure maintains similar efficacy and complication rates across all age groups.