title: [Evolution of the therapeutic management of varicoceles: Analysis of French national coding database (2006-2014)].
abstract: OBJECTIVE
  The varicocele is a venous abnormality frequently found in humans (1/10). Although the recommendations for management of this pathology are clear, two therapeutic options can be discussed: surgery or radiological embolisation. We wanted to study the evolution of the therapeutic management of varicocele using the French national coding database.
  
  
  METHODS
  Analysis of database from the "Agence technique de l'information sur l'hospitalisation" (ATIH) (number of surgical procedures and interventional radiology used in the treatment of varicocele for the period 2006-2014). The common classification of medical procedures (CCAM) was used to extract the codes for surgery and radiological embolisation. Then we recorded the corresponding "Groupes homogènes de malades" (GHM), excluding those with a different primary diagnosis of varicocele cure.
  
  
  RESULTS
  The number of surgical procedures and radiological embolisation performed for the treatment of varicocele increased from 3626 to 4007 procedures (+10.5%) between 2006 and 2014. While the frequency of interventional radiology (embolization pampiniform plexus) increased by 73.9%, surgery procedures (by direct approach or laparoscopy) decreased by 31.4% throughout the study (2006-2014). Thus in 2006, 60.2% of therapeutic procedures were performed surgically and 39.8% by radiological embolisation. In 2014, 37.4% of therapeutic procedures were performed surgically and 62.6% by embolization.
  
  
  CONCLUSIONS
  The analysis of French national database has confirmed a change in the therapeutic management of varicocele between 2006 and 2014. The minimally invasive treatment by radiological embolisation is currently favored in France and surgery pushed into the background. In 2014, more than one therapeutic management out of two was performed in interventional radiology.
  
  
  METHODS
  4.
authors.affiliation: Service d'urologie-transplantation, CHU d'Amiens - Picardie, site SUD, 80054 Amiens cedex 1, France; Laboratoire de recherche HeRVI (EA 3801), CURS, CHU d'Amiens - Picardie, 150, avenue de la Croix-Jourdain, 80480 Salouel, France. Electronic address: t.forzini@gmail.com.
authors.forename: T
authors.initials: T
authors.lastname: Forzini
authors.affiliation: Service d'urologie-transplantation, CHU d'Amiens - Picardie, site SUD, 80054 Amiens cedex 1, France.
authors.forename: E
authors.initials: E
authors.lastname: Alezra
authors.affiliation: Service d'urologie-transplantation, CHU d'Amiens - Picardie, site SUD, 80054 Amiens cedex 1, France.
authors.forename: M
authors.initials: M
authors.lastname: Demailly
authors.affiliation: Département d'information médicale (DIM), CHU d'Amiens - Picardie, site SUD, 80054 Amiens cedex 1, France.
authors.forename: E
authors.initials: E
authors.lastname: Lewandowski
authors.affiliation: Service d'urologie-transplantation, CHU d'Amiens - Picardie, site SUD, 80054 Amiens cedex 1, France; Laboratoire de recherche HeRVI (EA 3801), CURS, CHU d'Amiens - Picardie, 150, avenue de la Croix-Jourdain, 80480 Salouel, France.
authors.forename: F
authors.initials: F
authors.lastname: Saint
mesh_terms: D016208:Databases, Factual; D005602:France; D006801:Humans; D008297:Male; D013997:Time Factors; D013521:Urologic Surgical Procedures, Male / Q000379:methods / Q000639:trends; D014646:Varicocele / Q000628:therapy*
keywords: CCAM codage; Chirurgie; Codage CCAM; Embolisation; Embolization; Surgery; Varicocele; Varicocèle