Semin intervent Radiol 2022; 39(06): 581-586
DOI: 10.1055/s-0042-1759734
Review Article

Varicocele Embolization: Interventional Radiologist's Perspective

Pooya Torkian
1   Department of Radiology, Vascular and Interventional Radiology, University of Minnesota, Minneapolis, Minnesota
,
Michael Rosenberg
1   Department of Radiology, Vascular and Interventional Radiology, University of Minnesota, Minneapolis, Minnesota
,
Reza Talaie
1   Department of Radiology, Vascular and Interventional Radiology, University of Minnesota, Minneapolis, Minnesota
,
Jafar Golzarian
1   Department of Radiology, Vascular and Interventional Radiology, University of Minnesota, Minneapolis, Minnesota
› Author Affiliations
Funding This study was not supported by any funding.

Abstract

The goal of this article is to review the patient selection criteria, technical pearls, and outcomes of percutaneous varicocele embolization. This article will provide a brief overview of the history of the procedure, angiographic approach, and materials used in contemporary embolization. The success rates and complications of the varicocele embolization will also be discussed.



Publication History

Article published online:
20 December 2022

© 2022. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • Reference

  • 1 Paick S, Choi WS. Varicocele and testicular pain: a review. World J Mens Health 2019; 37 (01) 4-11
  • 2 Hassanin AM, Ahmed HH, Kaddah AN. A global view of the pathophysiology of varicocele. Andrology 2018; 6 (05) 654-661
  • 3 Lira Neto FT, Roque M, Esteves SC. Effect of varicocelectomy on sperm deoxyribonucleic acid fragmentation rates in infertile men with clinical varicocele: a systematic review and meta-analysis. Fertil Steril 2021; 116 (03) 696-712
  • 4 Agarwal A, Sharma R, Durairajanayagam D. et al. Spermatozoa protein alterations in infertile men with bilateral varicocele. Asian J Androl 2016; 18 (01) 43-53
  • 5 Masson P, Brannigan RE. The varicocele. Urol Clin North Am 2014; 41 (01) 129-144
  • 6 Puche-Sanz I, Flores-Martín JF, Vázquez-Alonso F, Pardo-Moreno PL, Cózar-Olmo JM. Primary treatment of painful varicocoele through percutaneous retrograde embolization with fibred coils. Andrology 2014; 2 (05) 716-720
  • 7 Wickham A, Vu D, El-Arabi A, Gatti JM. Adolescent varicocelectomy: Success at what cost? Clinical outcome and cost comparison of surgical ligation and percutaneous embolization. J Laparoendosc Adv Surg Tech A 2021; 31 (08) 942-946
  • 8 Mongioì LM, Mammino L, Compagnone M. et al. Effects of varicocele treatment on sperm conventional parameters: surgical varicocelectomy versus sclerotherapy. Cardiovasc Intervent Radiol 2019; 42 (03) 396-404
  • 9 Hung JWS, Yam FSD, Chung KLY. et al. Comparison of scrotal antegrade sclerotherapy and laparoscopic Palomo surgery in treatment of adolescent varicocele: a 15-year review. J Pediatr Urol 2018; 14 (06) 534.e1-534.e5
  • 10 Liu Q, Zhang X, Zhou F, Xi X, Lian S, Lian Q. Comparing endovascular and surgical treatments for varicocele: a systematic review and meta-analysis. J Vasc Interv Radiol 2022a; 33 (07) 834-840.e2
  • 11 Persad E, O'Loughlin CAA, Kaur S. et al. Surgical or radiological treatment for varicoceles in subfertile men. Cochrane Database Syst Rev 2021; 4: CD000479
  • 12 Zwiebel WJ, Pellerito JS. Introduction to Vascular Ultrasonography. Elsevier: Saunders Philadelphia; 2005
  • 13 Wright EJ, Young GP, Goldstein M. Reduction in testicular temperature after varicocelectomy in infertile men. Urology 1997; 50 (02) 257-259
  • 14 Gat Y, Gornish M, Navon U, Chakraborty J, Bachar GN, Ben-Shlomo I. Right varicocele and hypoxia, crucial factors in male infertility: fluid mechanics analysis of the impaired testicular drainage system. Reprod Biomed Online 2006; 13 (04) 510-515
  • 15 Wishahi MM. Detailed anatomy of the internal spermatic vein and the ovarian vein. Human cadaver study and operative spermatic venography: clinical aspects. J Urol 1991; 145 (04) 780-784
  • 16 Perdikakis E, Fezoulidis I, Tzortzis V, Rountas C. Varicocele embolization: anatomical variations of the left internal spermatic vein and endovascular treatment with different types of coils. Diagn Interv Imaging 2018; 99 (10) 599-607
  • 17 Valentino M, Bertolotto M, Derchi L, Pavlica P. Children and adults varicocele: diagnostic issues and therapeutical strategies. J Ultrasound 2014; 17 (03) 185-193
  • 18 Minhas S, Bettocchi C, Boeri L. et al; EAU Working Group on Male Sexual and Reproductive Health. European Association of Urology Guidelines on male sexual and reproductive health: 2021 update on male infertility. Eur Urol 2021; 80 (05) 603-620
  • 19 Chiles KA, Schlegel PN. Cost-effectiveness of varicocele surgery in the era of assisted reproductive technology. Asian J Androl 2016; 18 (02) 259-261
  • 20 Kroese AC, de Lange NM, Collins J, Evers JL. Surgery or embolization for varicoceles in subfertile men. Cochrane Database Syst Rev 2012; 10: CD000479
  • 21 Talaie R, Young SJ, Shrestha P, Flanagan SM, Rosenberg MS, Golzarian J. Image-guided treatment of varicoceles: a brief literature review and technical note. Semin Intervent Radiol 2016; 33 (03) 240-243
  • 22 Cassidy D, Jarvi K, Grober E, Lo K. Varicocele surgery or embolization: Which is better?. Can Urol Assoc J 2012; 6 (04) 266-268
  • 23 Medsinge A, Zajko A, Orons P, Amesur N, Santos E. A case-based approach to common embolization agents used in vascular interventional radiology. AJR Am J Roentgenol 2014; 203 (04) 699-708
  • 24 Makris GC, Efthymiou E, Little M. et al. Safety and effectiveness of the different types of embolic materials for the treatment of testicular varicoceles: a systematic review. Br J Radiol 2018; 91 (1088): 20170445
  • 25 Favard N, Moulin M, Fauque P. et al. Comparison of three different embolic materials for varicocele embolization: retrospective study of tolerance, radiation and recurrence rate. Quant Imaging Med Surg 2015; 5 (06) 806-814
  • 26 Gandini R, Konda D, Reale CA. et al. Male varicocele: transcatheter foam sclerotherapy with sodium tetradecyl sulfate–outcome in 244 patients. Radiology 2008; 246 (02) 612-618
  • 27 Abdulmaaboud MR, Shokeir AA, Farage Y, Abd El-Rahman A, El-Rakhawy MM, Mutabagani H. Treatment of varicocele: a comparative study of conventional open surgery, percutaneous retrograde sclerotherapy, and laparoscopy. Urology 1998; 52 (02) 294-300
  • 28 Ali A, Wirth S, Treitl KM, Treitl M. Treatment of male varicoceles by transcatheter polidocanol foam sclerotherapy: evaluation of clinical success, complications, and patients' satisfaction with regard to alternative techniques. Eur Radiol 2015; 25 (10) 2889-2897
  • 29 Urbano J, Cabrera M, Alonso-Burgos A. Sclerosis and varicocele embolization with N-butyl cyanoacrylate: experience in 41 patients. Acta Radiol 2014; 55 (02) 179-185