Varicocele may be treated with many different modalities, including radiologic and surgical approaches, but what is the best treatment remains controversial. The recurrence rate following varicocele repair ranges from 0.6% to 35% depending upon the technique used. We describe in detail a rare anatomical variant of the left internal spermatic veins and the appropriate treatment of recurrent varicocele with percutaneous scleroembolization. In case of recurrent varicocele after surgical repair, knowledge of anatomical variability of internal spermatic veins is essential for treatment planning.
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