title: Percutaneous treatment of varicocele with microcoil embolization: comparison of treatment outcome with laparoscopic varicocelectomy.
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.
authors.affiliation: Division of Vascular Surgery and Endovascular Therapy, Michael E, DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Carlos F
authors.initials: CF
authors.lastname: Bechara
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Weakley
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Kougias
authors.forename: Husam
authors.initials: H
authors.lastname: Athamneh
authors.forename: Patrick
authors.initials: P
authors.lastname: Duffy
authors.forename: Mohit
authors.initials: M
authors.lastname: Khera
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Peter H
authors.initials: PH
authors.lastname: Lin
mesh_terms: D000328:Adult; D003362:Cost-Benefit Analysis; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation*; D004867:Equipment Design; D017721:Hospital Costs; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000191:economics; D008026:Ligation; D008297:Male; D011859:Radiography; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D014646:Varicocele / Q000000981:diagnostic imaging / Q000191:economics / Q000601:surgery / Q000628:therapy*; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D055815:Young Adult