Vol.:(0123456789) 1 3
La radiologia medica
https://doi.org/10.1007/s11547-018-0968-2
VASCULAR AND INTERVENTIONAL RADIOLOGY
Varicocele, conventional laparoscopic ligation versus occluding
balloon embolization
Alessandro Motta
1
· Giuseppe Caltabiano
1
· Marco Pizzarelli
1
· Giovanni Failla
2
· Dragos Botezatu
3
·
Horia Muresanu
3
· Pietro Foti
4
· Sandro La Vignera
4
· Rosita Condorelli
4
· Stefano Palmucci
4
· Antonio Basile
4
Received: 17 June 2017 / Accepted: 5 December 2018
© Italian Society of Medical Radiology 2019
Abstract
Introduction Varicocele is a relatively complex pathology that afects 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.
Materials and methods 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.
Results and limitations Outcomes have been in line with the recent literature ones, allowing the occluding balloon emboliza-
tion 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-efectiveness analysis due to national diferences, limited sample
and lack of complete semen analysis pre- and postoperative.
Conclusion Both OBE and LL are safe and efective procedures in the treatment of varicocele, conceding OBE a slight
advantage in terms of hospital stay and full recovery to normal activity of patients.
Keywords Varicocele · Laparoscopic ligation · Occluding balloon · Embolization · Interventional radiology
* Alessandro Motta
alemotta.doc@gmail.com
Giuseppe Caltabiano
g.calta@yahoo.it
Marco Pizzarelli
ziopiz@hotmail.com
Giovanni Failla
failla.giovanni@gmail.com
Dragos Botezatu
dragosbotezatu@yahoo.com
Horia Muresanu
hmuresanu@gmail.com
Antonio Basile
antodoc@yahoo.com
1
Department of Interventional Radiology, “ARNAS”
Garibaldi Hospital, Maria di Gesù 4, 95100 Catania, CT,
Italy
2
Diagnostica per Immagini e Radiologia Interventistica,
Azienda Ospedaliera per l’Emergenza “Cannizzaro”, Via
Messina 829, 95126 Catania, CT, Italy
3
Vasile Goldis Western University, Str. Liviu Rebreanu, nr. 86,
Campusul Universitar “Vasile Goldis”, Arad, Romania
4
Department of Radiology and Radiotherapy, Policlinico
Universitario Gaspare Rodolico, Azienda Ospedaliera
Universitaria Policlinico Vittorio Emanuele, via Santa Sofa
n.29, 95100 Catania, Italy