EN
TÜRKÇE
Poster - 307
Percutaneous embolization as the first-line treatment for varicocele: still an effective therapeutic strategy?
Esther Comajuncosas Pérez, Ada Y Molina Caballero, Julio C Moreno Alfonso, Giuseppa Antona, Sara Hernández Martín, Alberto Pérez Martínez
Hospital Universitario de Navarra. Department of Pediatric Surgery. Pamplona; Spain
Purpose
In 2014, we published our therapeutic strategy with percutaneous embolization (PE) as the first option for treating varicocele. With an 80% remission rate in our series, we maintained this approach to this day despite controversy regarding the best treatment option for varicocele: PE vs surgery. We have evaluated our results after 10 more years of experience and advancements in interventional radiology.
Method
Retrospective study of patients with varicocele treated between 2014 and 2024. The clinical-radiological data were extracted from the electronic medical records, stored and processed using statistical software.
Results
We indicated PE in 74 out of 193 patients evaluated for varicocele: 4 had competent proximal spermatic veins (CPSV), in 2 the procedure was abandoned (multiple collaterals, inability to cannulate the vein), 65 had successful procedures with complete remission, 1 required a second PE to complete embolization, and 2 had recurrences during follow-up after initially effective PE. Seven patients underwent surgery: 6 laparoscopically and 1 via inguinal open surgery. Lymphatic preservation was performed in all patients except for one, who developed a postoperative lymphocele. The remission rate after PE and surgery was 95.58% and 100%, respectively. There were 5 complications in patients undergoing PE and 2 who underwent surgery (p=0.1095). Of the 69 patients referred to urology, 3 were treated for recurrence after PE in pediatric age with a resulting global PE resolution rate in our series of 92.65% with a maximum follow-up time of 6 years.
Conclusion
In our experience, PE remains an effective therapeutic option when experienced interventional radiologists are available, with few side effects and, performed on an outpatient basis, is cost-effective with results comparable to surgery.