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Published on: December 22, 2023
Percutaneous Embolization for Painful Varicocele: An 8-Year Tertiary Centre Experience
Philippe Haroun1, Salvatore Murgo1, Georges Mjaess2
1Department of Interventional Radiology, Erasme Hospital, Hôpital Universitaire de Bruxelles, Brussels, Belgium.
Insights
Varicocele embolization is an effective and safe treatment for scrotal pain in men. Further randomized trials are needed to establish optimal treatment strategies for varicocele.
Area of Science:
- Interventional Radiology
- Urology
- Male Reproductive Health
Background:
- Varicocele is a prevalent condition in men, potentially causing various clinical issues.
- Current treatment options for varicocele include surgical and non-surgical interventions.
- Evidence from randomized controlled trials comparing treatment modalities is lacking.
Purpose of the Study:
- To evaluate the safety and efficacy of varicocele embolization.
- To analyze outcomes of embolization procedures over an 8-year period.
Main Methods:
- Retrospective analysis of 182 varicocele embolization procedures.
- Data collection included demographics, procedure details, success rates, and complications.
- Telephone interviews were conducted for follow-up information.
Main Results:
- The technical success rate was 88.15%, with coils used in 91.94% of cases.
- Ultrasonographic success was achieved in 44.87% of patients.
- Clinical success for scrotal pain was 70.42%, with a 10.45% minor complication rate.
Conclusions:
- Varicocele embolization is a safe and efficient procedure for managing scrotal pain.
- Further randomized controlled trials are necessary to refine treatment protocols for varicocele.
Abstract:
Background: Varicocele is a common condition in men that can lead to several clinical problems. Treatment modalities include surgical and non‑surgical methods. There has been no randomized controlled trial proving the superiority of one treatment approach over another. Materials and methods: We conducted an 8‑year retrospective analysis of varicocele embolization procedures at our department of Interventional Radiology. Demographic data, procedure details, procedure success and complications were collected. Telephone interviews were also conducted at the time of the study. Results: A total of 182 interventions were performed. Median age of patients at presentation was 31 years (range, 12-71). Median follow‑up duration was 44.5 months (range, 3.4-106.9). Employed embolic agents were coils in 171/182 (91.94%) cases. Technical success rate was 88.15%. Ultrasonographic success was accomplished in 44.87% patients. Clinical success rate in patients referred for scrotal pain was 70.42%. Fluoroscopy time was 20.3 ± 14.9 min (mean ± SD), dose area product was 63.2 ± 50.5 Gy∙cm² (mean ± SD) and kinetic energy released per unit mass was 193.2 ± 173.6 (mean ± SD). Minor complications were encountered in 19/182 (10.45%) of the interventions. Conclusions: Varicocele embolization was found to be an efficient and safe procedure for patients referred for scrotal pain. Randomized controlled trials are warranted to elaborate treatment algorithms in varicocele patients.
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