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Varicocele, conventional laparoscopic ligation versus occluding balloon embolization

  • VASCULAR AND INTERVENTIONAL RADIOLOGY
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Abstract

Introduction

Varicocele is a relatively complex pathology that affects the pampiniform plexus of veins in the spermatic cord. Modern treatment involves both urological/surgical and interventional procedures. Our objective is to compare outcomes of conventional laparoscopic ligation (LL) and occluding balloon embolization (OBE) a percutaneous interventional procedure.

Materials and methods

We treated retrospectively a total of 98 patients, divided in two cohorts; arm A with 48 and arm B with 50 patients. Arm A patients underwent LL, while arm B ones were treated in interventional radiology suite, via OBE method. No comorbidities were reported, especially scrotal ones. Hence, all patients have been asked to respect 3 and 6 months’ follow-up, clinical examination and ultrasonography were performed. Age range of the entire sample: 15–45 years old, with average of 28 years. The study involved two European centers. We performed a comparative analysis (Fisher’s test) of intra-operative time, hospitalization and patient’s postoperative recovery time.

Results and limitations

Outcomes have been in line with the recent literature ones, allowing the occluding balloon embolization a small advantage for quicker operative average time, hospitalization needed and full recovery to normal activities for the patient. Main limitation was the unfeasibility of cost-effectiveness analysis due to national differences, limited sample and lack of complete semen analysis pre- and postoperative.

Conclusion

Both OBE and LL are safe and effective procedures in the treatment of varicocele, conceding OBE a slight advantage in terms of hospital stay and full recovery to normal activity of patients.

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References

  1. Hamada A, Esteves SC, Agarwal A (2016) Varicocele and male infertility, vol 1. SpringerBriefs in reproductive biology. Springer, Berlin, p 1

    Book  Google Scholar 

  2. Naughton CK, Nangia AK, Agarwal A (2001) Pathophysiology of varicoceles in male infertility. Hum Reprod Update 7(5):473–481

    Article  PubMed  CAS  Google Scholar 

  3. Abdel-Meguid TA, Al-Sayyad A, Tayib A, Farsi HM (2011) Does varicocele repair improve male infertility? An evidence-based perspective from a randomized, controlled trial. Eur Urol 59:455–461

    Article  PubMed  Google Scholar 

  4. Kantartzi PD, Goulis ChD, Goulis GD, Papadimas I (2007) Male infertility and varicocele: myths and reality. Hippokratia 11(3):99–104

    PubMed  CAS  PubMed Central  Google Scholar 

  5. Tu D, Glassberg KI (2010) Surgery illustrated—surgical atlas, laparoscopic varicocelectomy. BJU Int 106:1094–1104

    Article  PubMed  Google Scholar 

  6. Basile A, Failla G, La Vignera S et al (2014) Left spermatic vein retrograde sclerosis: comparison between sclerosant agent injection through a diagnostic catheter versus through an occluding balloon catheter. Radiol Med 120:483–488

    Article  PubMed  Google Scholar 

  7. Sarteschi LM, Menchini Fabris GM (2003) Ecografia andrologica. Athena audiovisuals, Modena

    Google Scholar 

  8. Bechara CF, Weakley SM, Kougias P et al (2009) Percutaneous treatment of varicocele with microcoil embolization: comparison of treatment outcome with laparoscopic varicocelectomy. Vascular 17(Suppl 3):S129–S136

    Article  PubMed  Google Scholar 

  9. Halpern J, Mittal S, Pereira K et al (2016) Percutaneous embolization of varicocele: technique, indications, relative contraindications, and complications. Asian J Androl 18:234–238

    Article  PubMed  Google Scholar 

  10. Grosso M, Balderi A, Antonietti A et al (2015) Endovascular sclerotherapy for male varicoceles: a retrospective analysis of 1619 patients. Austin J Surg 2(2):1051

    Google Scholar 

  11. Zanghí G, Di Stefano G, Furci M et al (2004) Surgical treatment of varicocele in day-surgery: our experience. G Chir 25(8–9):287–289

    PubMed  Google Scholar 

  12. Wang J, Xia SJ, Liu ZH et al (2014) Inguinal and subinguinal micro-varicocelectomy, the optimal surgical management of varicocele: a meta-analysis. Asian J Androl 17:74

    PubMed Central  Google Scholar 

  13. Iaccarino V, Venetucci P (2012) Interventional radiology of male varicocele: current status. Cardiovasc Interv Radiol 35:1263–12802

    Article  Google Scholar 

  14. Kroese ACJ, de Lange NM, Collins J, Evers JLH (2012) Surgery or embolization for varicoceles in subfertile men. Cochrane Database Syst Rev 17:10

    Google Scholar 

  15. Pieri S, Agresti P, Fiocca G et al (2006) Phlebographic classification of anatomic variants in the right internal spermatic vein confluence. Radiol Med 111:551–561

    Article  PubMed  CAS  Google Scholar 

  16. Gioppo A, Melchiorre F, Azzeroni R et al (2014) Analysis of radiation dose in varicocele embolization using a last generation C-arm: which risk for hereditary line? https://doi.org/10.1594/ecr2014/c-2178

  17. Gazzera C, Rampado O, Savio L et al (2006) Radiological treatment of male varicocele: technical, clinical, seminal and dosimetric aspects. Radiol Med 111:551–561

    Article  Google Scholar 

  18. Verstandig AG, Shamieh B, Shraibman V, Raveh D (2015) Radiation dose reduction in fluoroscopic procedures: left varicocele embolization as a model. Eur Radiol 25:1639–1645. https://doi.org/10.1007/s00330-014-3556-4

    Article  PubMed  Google Scholar 

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Correspondence to Alessandro Motta.

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The authors declare that they have no conflict of interest.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Motta, A., Caltabiano, G., Pizzarelli, M. et al. Varicocele, conventional laparoscopic ligation versus occluding balloon embolization. Radiol med 124, 438–443 (2019). https://doi.org/10.1007/s11547-018-0968-2

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  • DOI: https://doi.org/10.1007/s11547-018-0968-2

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