Department of Interventional Radiology, "ARNAS" Garibaldi Hospital, Maria di Gesù 4, 95100, Catania, CT, Italy.
Diagnostica per Immagini e Radiologia Interventistica, Azienda Ospedaliera per l'Emergenza "Cannizzaro", Via Messina 829, 95126, Catania, CT, Italy.
Radiol Med. 2019 May;124(5):438-443. doi: 10.1007/s11547-018-0968-2. Epub 2019 Jan 1.
Varicocele is a relatively complex pathology that affects the pampiniform plexus of veins in the spermatic cord. Modern treatment involves both urological/surgical and interventional procedures. Our objective is to compare outcomes of conventional laparoscopic ligation (LL) and occluding balloon embolization (OBE) a percutaneous interventional procedure.
We treated retrospectively a total of 98 patients, divided in two cohorts; arm A with 48 and arm B with 50 patients. Arm A patients underwent LL, while arm B ones were treated in interventional radiology suite, via OBE method. No comorbidities were reported, especially scrotal ones. Hence, all patients have been asked to respect 3 and 6 months' follow-up, clinical examination and ultrasonography were performed. Age range of the entire sample: 15-45 years old, with average of 28 years. The study involved two European centers. We performed a comparative analysis (Fisher's test) of intra-operative time, hospitalization and patient's postoperative recovery time.
Outcomes have been in line with the recent literature ones, allowing the occluding balloon embolization a small advantage for quicker operative average time, hospitalization needed and full recovery to normal activities for the patient. Main limitation was the unfeasibility of cost-effectiveness analysis due to national differences, limited sample and lack of complete semen analysis pre- and postoperative.
Both OBE and LL are safe and effective procedures in the treatment of varicocele, conceding OBE a slight advantage in terms of hospital stay and full recovery to normal activity of patients.
精索静脉曲张是一种较为复杂的病理，影响精索内蔓状静脉丛。现代治疗方法包括泌尿外科/手术治疗和介入治疗。我们的目的是比较传统腹腔镜结扎（LL）和经皮介入治疗的闭塞球囊栓塞（OBE）的结果。
我们回顾性治疗了总共 98 例患者，分为两组；A 组 48 例，B 组 50 例。A 组患者接受 LL，而 B 组患者在介入放射科通过 OBE 方法进行治疗。没有报告任何合并症，特别是阴囊合并症。因此，所有患者都被要求在 3 个月和 6 个月的随访时，进行临床检查和超声检查。整个样本的年龄范围为 15-45 岁，平均为 28 岁。该研究涉及两个欧洲中心。我们对手术时间、住院时间和患者术后恢复时间进行了比较分析（Fisher 检验）。
结果与最近的文献一致，使闭塞球囊栓塞在手术平均时间、住院时间和患者完全恢复正常活动方面具有优势。主要的局限性是由于国家差异、样本有限以及缺乏完全的精液分析，无法进行成本效益分析。
OBE 和 LL 都是治疗精索静脉曲张安全有效的方法，OBE 在住院时间和患者完全恢复正常活动方面略有优势。
