Sonaz Malekzadeh1,2, Rodrigo A Fraga-Silva3, Pierre-Henri Morère4, Alexandra Sorega4, Stephan Produit5, Nikolaos Stergiopulos3, Christophe Constantin4,6. 1. Department of Radiology, Sion Hospital, Sion, Switzerland. soonazmalakzadeh@gmail.com. 2. Service d'imagerie diagnostique et interventionnelle, Centre Hospitalier du Centre du Valais, Avenue du Grand-Champsec 80, 1950, Sion, Switzerland. soonazmalakzadeh@gmail.com. 3. Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland. 4. Department of Radiology, Sion Hospital, Sion, Switzerland. 5. Department of Pediatric Surgery, Sion Hospital, Sion, Switzerland. 6. Department of Radiology, Geneva Hospital, Geneva, Switzerland.
Abstract
PURPOSE: Percutaneous embolization and surgical repair are the current treatment options for varicocele, but determining method superiority remains controversial. In this retrospective study, we evaluate the technical success, complication and recurrence rates following percutaneous embolization in a pediatric group, which were compared to reported outcomes for surgical repairs. METHODS: Thirty children treated for percutaneous varicocele embolization were recruited. The side and grade of varicocele, symptoms, testicular asymmetry, mean recurrence time, total radiation dose and complications were evaluated. Recurrence and follow-up complications due to embolization were also reviewed. RESULTS: The venography showed retrograde filling of the internal spermatic vein with the identification of aberrantly fed vessels in 23 % of patients. None of the patients suffered from procedure complications except one who had venous injury which was treated with a sclerosing agent. The technical success rate was 93 % (28 patients) with a recurrence rate of 13 % (4 patients). Interestingly, the mean radiation dose used was 862.5 µGy m(2), 3 times lower than abdominal CT. CONCLUSION: Considering the intravascular nature of embolization, which aims to avoid testicular artery and spermatic cord damage (difficult to avoid with the surgical method), and consequently a lower complication rate, along with the same success rate and recurrence rate, our study supports that embolization is a superior method to surgical interventions.
PURPOSE: Percutaneous embolization and surgical repair are the current treatment options for varicocele, but determining method superiority remains controversial. In this retrospective study, we evaluate the technical success, complication and recurrence rates following percutaneous embolization in a pediatric group, which were compared to reported outcomes for surgical repairs. METHODS: Thirty children treated for percutaneous varicocele embolization were recruited. The side and grade of varicocele, symptoms, testicular asymmetry, mean recurrence time, total radiation dose and complications were evaluated. Recurrence and follow-up complications due to embolization were also reviewed. RESULTS: The venography showed retrograde filling of the internal spermatic vein with the identification of aberrantly fed vessels in 23 % of patients. None of the patients suffered from procedure complications except one who had venous injury which was treated with a sclerosing agent. The technical success rate was 93 % (28 patients) with a recurrence rate of 13 % (4 patients). Interestingly, the mean radiation dose used was 862.5 µGy m(2), 3 times lower than abdominal CT. CONCLUSION: Considering the intravascular nature of embolization, which aims to avoid testicular artery and spermatic cord damage (difficult to avoid with the surgical method), and consequently a lower complication rate, along with the same success rate and recurrence rate, our study supports that embolization is a superior method to surgical interventions.
Authors: C Esposito; G Monguzzi; M A Gonzalez-Sabin; R Rubino; L Montinaro; A Papparella; G Esposito; A Settimi; L Mastroianni; M Zamparelli; R Sacco; G Amici; R Damiano; N Innaro Journal: J Pediatr Surg Date: 2001-05 Impact factor: 2.545
Authors: A Okuyama; M Nakamura; M Namiki; M Takeyama; M Utsunomiya; H Fujioka; H Itatani; M Matsuda; K Matsumoto; T Sonoda Journal: J Urol Date: 1988-03 Impact factor: 7.450
Authors: B L Reyes; S O Trerotola; A C Venbrux; S J Savader; G B Lund; D S Peppas; S E Mitchell; J P Gearhart; R I White; F A Osterman Journal: J Vasc Interv Radiol Date: 1994 Jan-Feb Impact factor: 3.464
Authors: Michele Bertolotto; Simon Freeman; Jonathan Richenberg; Jane Belfield; Vikram Dogra; Dean Y Huang; Francesco Lotti; Karolina Markiet; Olivera Nikolic; Subramaniyan Ramanathan; Parvati Ramchandani; Laurence Rocher; Mustafa Secil; Paul S Sidhu; Katarzyna Skrobisz; Michal Studniarek; Athina Tsili; Ahmet Tuncay Turgut; Pietro Pavlica; Lorenzo E Derchi Journal: J Ultrasound Date: 2020-07-27