Lau Fiona S, Pereira John K, Jiwane Ashish, McGregor Priya
Department of Medical Imaging, Campus Centre, Prince of Wales & Sydney Children's Hospitals, Randwick, New South Wales, Australia.
University of New South Wales, Kensington, New South Wales, Australia.
J Med Imaging Radiat Oncol. 2025 Sep;69(6):662-667. doi: 10.1111/1754-9485.13878. Epub 2025 Jul 2.
Varicocele is a correctable cause of male infertility with management options including catheter embolisation of the testicular vein, done by Interventional Radiologists. Varicoceles can present in childhood and adolescence with scrotal pain or discomfort, or may be subclinical. It involves dilatation of the pampiniform plexus related to congestion and retrograde flow in the testicular vein. If left untreated, the pain and discomfort may impact the quality of life of the paediatric patient, and in the long term, infertility may ensue. However, limited data are available on the long-term clinical outcomes and complications of Varicocele embolisation in paediatric patients.
Retrospective cohort study of 14 years of endovascular Varicocele embolisation at a single-operator tertiary paediatric centre.
Eighty-four patients with a median age of 14 years (range 8-17 years) were identified. The varicoceles were predominantly of grade 1 or 2. 99% of patients had unilateral left-sided varicoceles. One patient had bilateral varicoceles. This study demonstrated that the technical success rate of endovascular embolisation is 94% and the clinical success rate is 98%. 84% reported feeling well in the immediate postprocedural period. 86% of cases reported excellent long-term progress. A small proportion (10%) experienced long-term discomfort or pain. There were no cases of relapse.
Endovascular embolisation is a successful technique for the management of Varicocele in paediatric patients, with good immediate and long-term clinical outcomes. It has low recurrence rates.
精索静脉曲张是男性不育的一个可纠正病因，其治疗选择包括由介入放射科医生进行的睾丸静脉导管栓塞术。精索静脉曲张可在儿童期和青春期出现阴囊疼痛或不适，也可能是亚临床的。它涉及蔓状静脉丛的扩张，与睾丸静脉的充血和逆流有关。如果不治疗，疼痛和不适可能会影响儿科患者的生活质量，从长远来看，可能会导致不育。然而，关于儿科患者精索静脉曲张栓塞术的长期临床结果和并发症的数据有限。
对一家三级儿科中心单一操作者进行的14年血管内精索静脉曲张栓塞术进行回顾性队列研究。
确定了84例患者，中位年龄为14岁（范围8 - 17岁）。精索静脉曲张主要为1级或2级。99%的患者为单侧左侧精索静脉曲张。1例患者为双侧精索静脉曲张。本研究表明，血管内栓塞术的技术成功率为94%，临床成功率为98%。84%的患者在术后即刻感觉良好。86%的病例报告长期进展良好。一小部分（10%）患者经历了长期不适或疼痛。没有复发病例。
血管内栓塞术是治疗儿科患者精索静脉曲张的一种成功技术，具有良好的近期和长期临床效果。其复发率低。
