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2018 | 18 | 73 | 90–95
Article title

Selecting patients for embolization of varicoceles based on ultrasonography

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PL
Kwalifikacja ultrasonograficzna do zabiegu embolizacji żylaków powrózka nasiennego
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Abstracts
EN
Aim: The aim of the study was to assess patient selection for embolization of varicoceles based on ultrasonography. An additional objective of the work was to evaluate the results of endovascular treatment. Material and methods: From January 2015 till August 2017, 53 patients with varicoceles diagnosed in an ultrasound examination underwent endovascular treatment in the Department of Interventional Radiology and Neuroradiology in Lublin, Poland. Each ultrasound examination was performed using the Logiq 7 GE Medical System with a linear probe at 6–12 MHz using the B-mode and Doppler functions. The study was performed in both the supine and standing position of the patient. The morphological structures of the scrotum and the width of the pampiniform venous plexus were assessed. Based on clinical signs and symptoms as well as ultrasound findings, the patients were selected for endovascular treatment. This procedure involved the implantation of coils in the distal and proximal parts of the testicular vein and administration of a sclerosing agent between the coils. Results: Varicoceles were confirmed in all patients during a color Doppler scan. Diagnostic venography confirmed venous stasis or retrograde flow in the testicular vein and widened vessels of the pampiniform venous plexus over 2 mm in diameter in all patients undergoing endovascular treatment. The diagnostic efficacy of ultrasound was 100%. The technical success of the procedure was 89%. One patient had a recurrence of varicose veins (2.2%). There were no complications in any of the patients. Conclusions: Ultrasound is the preferred method in the diagnosis of varicoceles and selection for their treatment. Testicular vein embolization is a minimally invasive procedure characterized by high efficacy and safety.
PL
Cel: Celem pracy jest ocena ultrasonograficznej kwalifikacji do zabiegu embolizacji żylaków powrózka nasiennego, a także ocena wyników zabiegu wewnątrznaczyniowego.Materiał i metoda: W okresie od stycznia 2015 do sierpnia 2017 roku w Zakładzie Radiologii Zabiegowej i Neuroradiologii w Lublinie poddano leczeniu zabiegowemu 53 chorych, u których rozpoznano w badaniu ultrasonograficznym żylaki powrózka nasiennego. Każde badanie ultrasonograficzne wykonywano aparatem Logiq 7 GE Medical System przy użyciu sondy linearnej o częstotliwości 6–12 MHz z wykorzystaniem opcji B-mode oraz dopplerowskich. Badanie przeprowadzono zarówno w pozycji leżącej, jak i stojącej chorego. Oceniano morfologiczne struktury worka mosznowego i szerokość naczyń splotu wiciowatego. Na podstawie objawów klinicznych i wyniku badania ultrasonograficznego chorzy byli kwalifikowani do leczenia wewnątrznaczyniowego. Zabieg polegał na implantacji spiral w odcinku dystalnym i proksymalnym żyły jądrowej i podawaniu pomiędzy spirale substancji obliterującej naczynie.Wyniki: U wszystkich chorych w wykonanym badaniu ultrasonograficznym z opcją kolorowego dopplera potwierdzono występowanie żylaków powrózka nasiennego. U wszystkich chorych poddanych zabiegowi embolizacji podczas diagnostycznej flebografii potwierdzono występowanie zastoju żylnego lub refluksu wstecznego w żyle jądrowej oraz poszerzone naczynia żylne, powyżej 2 mm średnicy. Skuteczność rozpoznania żylaków powrózka nasiennego za pomocą badania ultrasonograficznego wyniosła 100%. Powodzenie techniczne procedury wyniosło 89%. U jednego chorego nastąpił nawrót żylaków (2,2%). U żadnego chorego nie wystąpiły jakiekolwiek powikłania. Wnioski: Badanie ultrasonograficzne jest metodą z wyboru w rozpoznawaniu żylaków powrózka nasiennego i kwalifikowaniu chorych do zabiegu. Embolizacja żyły jądrowej to zabieg charakteryzujący się wysoką skutecznością i bezpieczeństwem w leczeniu żylaków powrózka nasiennego.
Discipline
Publisher

Year
Volume
18
Issue
73
Pages
90–95
Physical description
Contributors
  • Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Lublin, Poland
  • Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Lublin, Poland
author
  • Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Lublin, Poland
author
  • Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Lublin, Poland
author
  • Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Lublin, Poland
  • Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Lublin, Poland
author
  • Department of Radiology and Nuclear Medicine, Otto von Guericke University, Magdeburg, Niemcy
  • Department of Radiology and Nuclear Medicine, Otto von Guericke University, Magdeburg, Niemcy
  • Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Lublin, Poland
References
  • 1. Franken DR, Acosta AA, Kruger TF, Lombard CJ, Oehninger S, Hodgen GD: The hemizona assay: Its role in identifying male factor infertility in assisted reproduction. Fertil Steril 1993; 59: 1075–1080.
  • 2. Arslan H, Sakarya ME, Atilla MK: Clinical value of power Doppler sonography in the diagnosis of varicocele. J Clin Ultrasound 1998; 26: 229.
  • 3. Masson P, Brannigan RE: The varicocele. Urol Clin North Am 2014; 41: 129–144.
  • 4. Gorelick JI, Goldstein M: Loss of fertility in men with varicocele. Fertil Steril 1993; 59: 613–616.
  • 5. Practice Committee of the American Society for Reproductive Medicine; Society for Male Reproduction and Urology: Report on varicocele and infertility: A committee opinion. Fertil Steril 2014; 102: 1556–1560.
  • 6. Lorenc T, Krupniewski L, Palczewski P, Gołębiowski M: The value of ultrasonography in the diagnosis of varicocele. J Ultrason 2016; 16: 359–370.
  • 7. Belay RE, Huang GO, Shen JK, Ko EY: Diagnosis of clinical and subclinical varicocele: how has it evolved? Asian J Androl 2016; 18: 182–185.
  • 8. Freund J, Handelsman DJ, Bautovich GJ, Conway AJ, Morris JG: Detection of varicocele by radionuclide blood-pool scanning. Radiology 1980; 137: 227–230.
  • 9. Paz A, Melloul M: Comparison of radionuclide scrotal blood-pool index versus gonadal venography in the diagnosis of varicocele. J Nucl Med 1998; 39: 1069–1074.
  • 10. Kim YS, Kim SK, Cho IC, Min SK: Efficacy of scrotal Doppler ultrasonography with the Valsalva maneuver, standing position, and resting-Valsalva ratio for varicocele diagnosis. Korean J Urol 2015; 56: 144–149.
  • 11. Semiz I, Tokgöz O, Tokgoz H, Voyvoda N, Serifoglu I, Erdem Z: The investigation of correlation between semen analysis parameters and intraparenchymal testicular spectral Doppler indices in patients with clinical varicocele. Ultrasound Q 2014; 30: 33–40.
  • 12. Gonda RL Jr, Karo JJ, Forte RA, O’Donnell KT: Diagnosis of subclinical varicocele in infertility. AJR Am J Roentgenol 1987; 148: 71–75.
  • 13. Aydos K, Baltaci S, Salih M, Anafarta K, Bedük Y, Gülsoy U: Use of color Doppler sonography in the evaluation of varicoceles. Eur Urol 1993; 24: 221–225.
  • 14. Eskew LA, Watson NE, Wolfman N, Bechtold R, Scharling E, Jarow JP: Ultrasonographic diagnosis of varicoceles. Fertil Steril 1993; 60: 693–697.
  • 15. Mihmanli I, Kurugoglu S, Cantasdemir M, Zulfikar Z, Halit Yilmaz M, Numan F: Color Doppler ultrasound in subclinical varicocele: An attempt to determine new criteria. Eur J Ultrasound 2000; 12: 43–48. 16.
  • 16. Kim SW: Varicocele and male infertility. J Korean Med Assoc 2012; 55: 37–46.
  • 17. Beddy P, Geoghegan T, Browne RF, Torreggiani WC: Testicular varicoceles. Clin Radiol 2005; 60: 1248–1255.
  • 18. Gat Y, Bachar GN, Zukerman Z, Belenky A, Gorenish M: Physical examination may miss the diagnosis of bilateral varicocele: A comparative study of 4 diagnostic modalities. J Urol 2004; 172: 1414–1417.
  • 19. Goldberg S: Diagnostic Ultrasound. Lippincott-Raven, Philadelphia 1998.
  • 20. Trum JW, Gubler FM, Laan R, van der Veen F: The value of palpation, varicoscreen contact thermography and colour Doppler ultrasound in the diagnosis of varicocele. Hum Reprod 1996; 11: 1232–1235.
  • 21. Lurvey R, Durbin-Johnson B, Kurzrock EA: Adolescent varicocele: A large multicenter analysis of complications and recurrence in academic programs. J Pediatr Urol 2015; 11: 186.e1–186.e16.
  • 22. Zampieri N, Chironi C, Sulpasso M: Treatment of varicocele with transfemoral retrograde sclero-embolization in pediatric patients under local anesthesia. Minerva Pediatr 2015; 67: 227–229.
  • 23. Diamond D: Adolescent versus adult varicoceles – how do evaluation and management differ? J Urol 2009; 181: 2418–2419.
  • 24. Riccabona M, Oswald J, Koen M, Lusuardi L, Radmayr C, Bartsch G: Optimizing the operative treatment of boys with varicocele: Sequential comparison of 4 techniques. J Urol 2003; 169: 666–668.
  • 25. Kocvara R, Dvorácek J, Sedlácek J, Díte Z, Novák K: Lymphatic sparing laparoscopic varicocelectomy: A microsurgical repair. J Urol 2005; 173: 1751–1754.
  • 26. Hassan JM, Adams MC, Pope JC 4th, Demarco RT, Brock JW 3rd: Hydrocele formation following laparoscopic varicocelectomy. J Urol 2006; 175: 1076–1079.
  • 27. Misseri R, Gershbein AB, Horowitz M, Glassberg KI: The adolescent varicocele. II: The incidence of hydrocele and delayed recurrent varicocele after varicocelectomy in a long-term follow-up. BJU Int 2001; 87: 494–498.
  • 28. Feber KM, Kass EJ: Varicocelectomy in adolescent boys: Long-term experience with the Palomo procedure. J Urol 2008; 180: 1657–1660.
  • 29. Schiff J, Kelly C, Goldstein M, Schlegel P, Schelgel P, Poppas D: Managing varicoceles in children: Results with microsurgical varicocelectomy. BJU Int 2005; 95: 399–402.
  • 30. Wang J, Xia SJ, Liu ZH, Tao L, Ge JF, Xu CM et al.: Inguinal and subinguinal micro-varicocelectomy, the optimal surgical management of varicocele: A meta-analysis. Asian J Androl 2015; 17: 74–80.
  • 31. VanderBrink BA, Palmer LS, Gitlin J, Levitt SB, Franco I: Lymphatic- -sparing laparoscopic varicocelectomy versus microscopic varicocelectomy: Is there a difference? Urology 2007; 70: 1207–1210.
  • 32. Cassidy D, Jarvi K, Grober E, Lo K: Varicocele surgery or embolization: Which is better? Can Urol Assoc J 2012; 6: 266–268.
  • 33. Bou Nasr E, Binhazzaa M, Almont T, Rischmann P, Soulie M, Huyghe E: Subinguinal microsurgical varicocelectomy vs. percutaneous embolization in infertile men: Prospective comparison of reproductive and functional outcomes. Basic Clin Androl 2017; 27: 11.
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bwmeta1.element.psjd-0a318c2d-6827-4444-b54a-5c39702be602
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