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Author Spotlight: Advancing Varicocele Treatment Through Enhanced Surgical Techniques
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Practice patterns in the surgical approach for adolescent varicocelectomy.

Miriam Harel1, Katherine W Herbst2, Eric Nelson1

  • 1University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030 USA ; Connecticut Children's Medical Center, 282 Washington Street, Hartford, CT 06106 USA.

Springerplus
|December 24, 2015
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Summary

Laparoscopic varicocelectomy was the most common approach for adolescents between 2003-2012. Microsurgical techniques, standard in adults, were rarely reported in this age group, possibly due to underreporting.

Keywords:
AdolescentChildUrologic surgical proceduresVaricocele

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Area of Science:

  • Urology
  • Pediatric Surgery
  • Health Services Research

Background:

  • Varicocele is a common condition in adolescents.
  • The optimal surgical approach for adolescent varicocelectomy is debated.
  • Microsurgical repair is the gold standard for adult infertility but less studied in adolescents.

Purpose of the Study:

  • To describe surgical approach patterns for adolescent varicocelectomy.
  • To analyze trends in surgical approach selection over time.
  • To compare the utilization of laparoscopic, open, and microsurgical techniques.

Main Methods:

  • Retrospective analysis of the Pediatric Health Information System (PHIS) database (2003-2012).
  • Inclusion of patients aged 10+ with varicocele and varicocelectomy CPT codes.
  • Identification of microsurgical approach via CPT code 69990.

Main Results:

  • 2528 adolescent varicocelectomies were identified across 38 hospitals.
  • Laparoscopic approach was most common (53.6%).
  • Microsurgical approach was reported in only 2% of open procedures, with stable laparoscopic use over time.

Conclusions:

  • Laparoscopic varicocelectomy predominated in adolescents from 2003-2012.
  • Microsurgical techniques were infrequently reported in this cohort.
  • Underreporting of microsurgical use in the PHIS database is probable.