VARICOCELE EMBOLIZATION FOLLOWING FAILURE OF VARICOCELECTOMY: A CASE SERIES AND REVIEW OF LITERATURE

Zain Badar, Michael Rachun, Zerwa Farooq, Megan Calabrese, Anthony Mohamed, Mohammed Jawed

Abstract


Varicocelectomy remains the same mainstay of treatment for varicoceles. However with growing focus on minimally invasive techniques, recent literature has investigated the use of venous embolization for the treatment of varicoceles in patients with recurrence after surgical treatment. Embolization has many advantages, including use of local anesthesia, lower operating time, decreased risk of hydrocele and faster recovery times. In addition to this direct visualization of the vasculature during embolization allows for identification of any anatomic variants or collateral vessel accounting for the recurrence. This permits more definitive treatment in case of prior surgical failure. We present a case series where venous embolization is successfully done following failure of varicoclectomy. For patients who experience recurrence after a varicocelectomy, we recommend consideration for varicocele embolization.

Varicocelectomy remains the same mainstay of treatment for varicoceles. However, with growing focus on minimally invasive techniques, recent literature has investigated the use of venous embolization for the treatment of varicoceles in patients with recurrence after surgical treatment. Embolization has many advantages, including use of local anaesthesia, lower operating time, decreased risk of hydrocele and faster recovery times. In addition to this direct visualization of the vasculature during embolization allows for identification of any anatomic variants or collateral vessel accounting for the recurrence. This permits more definitive treatment in case of prior surgical failure. We present a case series where venous embolization is successfully done following failure of varicocelectomy. For patients who experience recurrence after a varicocelectomy, we recommend consideration for varicocele embolization.

Keywords: Varicocelectomy; Varicocele embolization; Recurrence


Full Text:

PDF

References


French DB, Desai NR, Agarwal A. Varicocele repair: does it still have a role in infertility treatment? Curr Opin Obstet Gynecol 2008;20(3):269–74.

Elbendary MA, Elbadry AM. Right subclinical varicocele: how to manage in infertile patients with clinical left varicocele? Fertil Steril 2009;92(6):2050–3.

Punekar SV, Prem AR, Ridhorkar VR, Deshmukh HL, Kelkar AR. Post-surgical recurrent varicocele: efficacy of internal spermatic venography and steel-coil embolization. Br J Urol 1996;77(1):124–8.

Cayan S, Shavakhabov S, Kadioglu A. Treatment of palpable varicocele in infertile men: a meta-analysis to define the best technique. J Androl 2009;30(1):33–40.

Jargiello T, Drelich-Zbroja A, Falkowski A, Sojka M, Pyra K, Szczerbo-Trojanowska M. Endovascular transcatheter embolization of recurrent postsurgical varicocele: anatomic reasons for surgical failure. Acta Radiol 2015;56(1):63–9.

Moon KH, Cho SJ, Kim KS, Park S, Park S. Recurrent Varicoceles: Causes and Treatment Using Angiography and Magnification Assisted Subinguinal Varicocelectomy. Yonsei Med J 2012;53(4):723–8.

Storm DW, Hogan MJ, Jayanthi VR. Initial experience with percutaneous selective embolization: A truly minimally invasive treatment of the adolescent varicocele with no risk of hydrocele development. J Pediatr Urol 2010;6(6):567–71.

Halpern J, Mittal S, Pereira K, Bhatia S, Ranjith R. Percutaneous embolization of varicocele: technique, indications, relative contraindications, and complications. Asian J Androl 2016;18(2):234–8.

Puche-Sanz I, Flores-Martin JF, Vasquez-Alonzo F, Pardo-Moreno PL, Cozar-Olmo JM. Primary treatment of painful varicocele through percutaneous retrograde embolization with fibred coils. Andrology 2014;(2):716–20.

Kim J, Shin JH, Yoon HK, Ko GY, Gwon DI, Kim EY, Sung KB. Persistent or recurrent varicoele after failed varicocoelectomy: Outcome in patients treated using percutaneous transcatheter embolization. Clin Radiol 2011;67(4):359–65.


Refbacks

  • There are currently no refbacks.


Contact Number: +92-992-382571

email: [jamc] [@] [ayubmed.edu.pk]