In men who undergo embolization of varicoceles as an infertility treatment, sperm motility prior to treatment is an important predictor of pregnancy in their female partners. Sebastian Flacke, M.D., Ph.D., and colleagues found in a study of 223 patients that baseline sperm motility was the only tested pre-treatment factor that significantly predicted a sired pregnancy. Hormone levels, clinical grading of varicoceles, Doppler ultrasound findings and other semen parameters did not reach statistical significance, according to the study.

"This is the first description of such a prognostic factor for treatment success in infertile males with varicoceles," the researchers write. "Assessing sperm motility prior to the embolization of varicoceles in infertile men may help identify those couples that may require additional treatment besides the embolization."

Most patients demonstrated a significant improvement in sperm motility at three-month follow-up, though average values remained in the abnormal range, Flacke and colleagues observed. Of the 173 patients who answered a follow-up questionnaire, 45 percent reported a pregnancy. The researchers concluded that embolization of the spermatic vein in infertile males significantly improves semen parameters and in this study was associated with increased likelihood of pregnancy. "Patients with less impaired sperm motility appear to benefit the most from this treatment, if a sired pregnancy is considered as the main factor in judging successful clinical outcome," the researchers write.

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Pre-Medication to Reduce Discomfort with Screening Mammography

This article is currently available online and will be published in the September issue of Radiology.

Pre-medication with lidocaine gel can significantly improve the experience for women who experience greater than average discomfort during mammography, researchers have found.

In a study of 418 participants who were surveyed before and after a screening mammogram, Colleen K. Lambertz, M.S.N., M.B.A., F.N.P., and colleagues at Luke's Mountain States Tumor Institute in Boise, Idaho, found that discomfort significantly decreased participants' satisfaction with the mammography experience, with level of satisfaction affecting participants' plans for future mammograms. Women who experienced greater than average discomfort were more likely to report this discomfort and women who delayed their study mammograms due to fear of discomfort were less likely to plan to get a mammogram the next year. "These results indicate that expectation of discomfort, anxiety and perceived discomfort negatively influence women's satisfaction with screening mammography and their likelihood to undergo regular screening," the researchers write.

Some participants received pre-medication with acetaminophen, ibuprofen and/or topical gel with 4 percent lidocaine prior to the study mammogram. The lidocaine gel, the researchers observed, provided a significant reduction in discomfort and increased satisfaction with the experience, even when the gel was removed up to 60 minutes before the mammogram. "This gel is a readily available, over the counter, topical anesthetic that is easy to apply and remove," the researchers write. "Lidocaine gel would be especially useful to women who expect discomfort and may be tempted to delay or avoid screening mammography." Lambertz and colleagues also propose that the gel could be applied at home before scheduled mammograms by the patients themselves, thus reducing additional facility costs.

Venograms depict the interventional approach: A 5-F spermatic catheter is introduced through right groin access and placed in the left renal vein.

(a) To increase intraabdominal pressure, patient is asked to perform a Valsalva maneuver, and retrograde venogram shows a type I varicocele with a single internal spermatic vein with insufficient confluence valve function. (b) Spermatic catheter is exchanged for an end-hole catheter. (c) Second injection through end-hole catheter can be used to clearly delineate distal anatomy. After distal embolization of the internal spermatic vein with platinum coils at the level of the sacroiliac joint, the sclerosing agent is injected while slowly retracting the catheter. (d) The distal internal spermatic vein is manually externally compressed to avoid inadvertent injection into the scrotum.

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Media Coverage of Radiology

In June, media outlets carried 349 news stories generated by articles appearing in Radiology. These stories reached an estimated 118 million people.

A news release promoted findings from a study on the use of a new calcium scoring method to better predict a person's risk of cardiac event (Radiology 2008;247:669-678).

Print and wire coverage included the National Post (Ontario, Canada), Oklahoman (Oklahoma City), Daily Herald (Arlington Heights, Ill.), Health and Medicine Week, Diagnostic Imaging, Reuters, Health Day News and Asian News International.

Broadcast coverage included WBBM-TV (Chicago), WMGM-TV (Philadelphia), WKYC-TV (Cleveland), KMTR-TV (Eugene, Ore.), WJAR-TV (Providence, R.I.), WSLS-TV (Roanoke, Va.), WAVE-TV (Louisville, Ky.) and KCBD-TV (Lubbock, Texas).

Web placements included AOL.com, Yahoo! News, MSNBC.com, MSN.com, Washingtonpost.com, USNews.com and Forbes.com.

August Outreach Focuses on Clinical Trials

In August, RSNA's 60-Second Checkup radio program addressed clinical trials, including information on the different types of trials and what results may mean for patients.