Percutaneous treatment of varicocele with microcoil embolization: Comparison of treatment outcome with laparoscopic varicocelectomy

Carlos F. Bechara, Sarah M. Weakley, Panagiotis Kougias, Husam Athamneh, Patrick Duffy, Mohit Khera, Katsuhiro Kobayashi, Peter H. Lin

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

Successful treatment of a testicular varicocele, which can result in scrotal pain and swelling as well as male subfertility, can be accomplished via operative ligation of the varicocele or interventional treatment with coil embolization of the testicular vein. This study compared the treatment outcome of percutaneous embolization treatment versus laparoscopic varicocelectomy in patients with symptomatic varicoceles. Patients with varicoceles undergoing either laparoscopic varicocelectomy or percutaneous coil embolization of the testicular vein during a recent 5-year period were analyzed. Treatment outcome and hospital costs of these two minimally invasive treatment modalities were compared. Forty-one patients underwent percutaneous coil embolization of the testicular vein, which were compared with a cohort of 43 patients who underwent laparoscopic varicocelectomy. Technical success in interventional and laparoscopic treatment was 95% and 100%, respectively. The mean operative time or procedural time was 63 ± 13 minutes and 52 ± 25 minutes for interventional and laparoscopic cohorts (not significant), respectively. Embolization treatment resulted in two recurrent varicoceles (4.8%) compared to one patient following laparoscopic repair (2.3%, not significant). Embolization treatment was associated with a lower complication rate than laparoscopic repair (9.7% vs 16.3%, p = .03). Regarding cost analysis, no significant difference in hospital cost was noted between the interventional or laparoscopic treatment strategies. Both laparoscopic varicocelectomy and coil embolization are effective treatment modalities for varicoceles. With lower treatment complication rates in the interventional treatment group, coil embolization of the testicular vein offers treatment advantage compared with laparoscopic repair in patients with varicoceles.

Original languageEnglish (US)
Pages (from-to)S129-S136
JournalVascular
Volume17
Issue numberSUPPL. 3
DOIs
StatePublished - Dec 1 2009
Externally publishedYes

Keywords

  • Laparoscopic varicocelectomy
  • Microcoil embolotherapy
  • Percutaneous embolization
  • Varicocele embolization

ASJC Scopus subject areas

  • Surgery
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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