Comparison of scrotal antegrade sclerotherapy and laparoscopic Palomo surgery in treatment of adolescent varicocele: A 15-year review

Hung, Judy W.S.; Yam, Felix S.D.; Chung, Kenneth L.Y.; Lau, Ambrose K.W.; Leung, Yvonne C.L.; Liu, Clarence C.W.; Tang, Paula M.Y.; Chao, Nicholas S.Y.; Leung, Michael W.Y.; Liu, Kelvin K.W.

doi:10.1016/j.jpurol.2018.04.027

Cited by 12 publications

(10 citation statements)

References 21 publications

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“…The number of data sets for the different techniques included the following: inguinal microsurgical with artery- and lymphatic-sparing ( n = 8) 17–24 ; subinguinal microsurgical with artery- and lymphatic-sparing ( n = 11) 21,22,25–33 ; laparoscopic mass-ligation/division ( n = 23) 20,26,34–54 ; laparoscopic lymphatic-sparing ( n = 8) 32,35,39,50,55–58 ; laparoscopic artery-sparing ( n = 5), 38,53,59–61 antegrade embolization/sclerotherapy ( n = 7) 36,54,62–66 ; and retrograde embolization/sclerotherapy ( n = 6). 67…”

Section: Resultsmentioning

confidence: 99%

“…We identified a total of 36 data sets (31 studies) on 3 different types of laparoscopic techniques ( Tables 4 – 6 ). 20 , 26 , 32 , 34 – 61 A total of 14 studies reported on laparoscopic mass-ligation/division alone 34 , 37 , 40 – 49 , 51 , 52 ; 4 studies reported on laparoscopic lymphatic-sparing alone 55 – 58 and 3 studies reported on laparoscopic artery-sparing alone. 59 – 61 Three studies compared laparoscopic mass-ligation/division to laparoscopic lymphatic-sparing techniques, 35 , 39 , 50 two studies compared laparoscopic mass-ligation/division to laparosc...…”

Section: Resultsmentioning

confidence: 99%

“… 59 – 61 Three studies compared laparoscopic mass-ligation/division to laparoscopic lymphatic-sparing techniques, 35 , 39 , 50 two studies compared laparoscopic mass-ligation/division to laparoscopic artery-sparing techniques. 38 , 53 Two study compared the laparoscopic mass-ligation/division technique to the antegrade embolization/sclerotherapy technique 36 , 54 ; one study compared the laparoscopic mass-ligation/division technique to the inguinal artery- and lymphatic-sparing with optical magnification technique, 20 one study compared the laparoscopic mass-ligation/division technique to the subinguinal artery- and lymphatic-sparing with optical magnification technique, 26 and one study compared the laparoscopic lymphatic-sparing technique to the subinguinal artery- and lymphatic-sparing with optical magnification technique. 32 There were three RCTs, 36 , 39 , 57 two prospective studies.…”

Section: Resultsmentioning

confidence: 99%

“…36,54,62,65,66 Indeed, Hung et al recommended that, for patients with anomalous drainage, the antegrade sclerotherapy should not proceed, as the incorrect cannulation of spermatic cord superficial veins could lead to significant complications because of occlusion of veins in other districts. 54 Complications for the retrograde approach include pampiniform plexus thrombophlebitis, groin hematoma and interval spermatic vein perforation with spillage of contrast. 67,68,70,72 Technical failure (defined as the inability to complete the procedure and/or the need for conversion to a different procedure) is also an issue with embolization/sclerosing techniques, particularly with the retrograde approach.…”

Section: Therapeutic Advances In Urologymentioning

confidence: 99%

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Outcome following the surgical management of varicocele in children and adolescents: a systematic review and meta-analysis

Tandon,

Bennett,

Mark Nataraja

et al. 2023

Therapeutic Advances in Urology

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Background: The ideal surgical approach for the management of varicocele in children and adolescents remains controversial. Several techniques are available including artery- or lymphatic-sparing with optical magnification ( via open inguinal or sub-inguinal approach), laparoscopic, antegrade and retrograde embolization/sclerotherapy. Objectives: We aimed to appraise the clinical outcomes of these techniques in children and adolescents. Data Sources and Methods: A systematic review was conducted (1997–2023). Meta-analysis or proportional meta-analysis for non-comparative studies (Freeman-Tukey transformation) using the random effects model was conducted. Results are expressed as overall proportion % and 95% conﬁdence interval (CI). Results: We identified 1910 studies; 632 duplicates were removed, 1278 were screened, 203 were reviewed and 56 were included, with 12 reporting on 2 different techniques (total of 68 data sets). Optical magnification via inguinal approach (498 cases): recurrence 2.5% (0.6–5.6), hydrocele 1.6% (0.47–3.4), testicular atrophy 1% (0.3–2.0), complications 1.1% (0.2–2.6); optical magnification via sub-inguinal approach (592 cases): recurrence 2.1% (0.7–4.4), hydrocele 1.26% (0.5–2.3), testicular atrophy 0.5% (0.1–1.3), complications 4% (1.0–8.8). Laparoscopic with mass-ligation/division (1943 cases): recurrence 2.9% (1.5–4.6), hydrocele 11.4% (8.3–14.9); complications 1.5% (0.6–2.9); laparoscopic with lymphatic-sparing (974 cases): recurrence 2.4% (1.5–3.5), hydrocele 1.2% (0.45–3.36), complications 1.2% (0.05–3.9); laparoscopic with artery-sparing (228 cases): recurrence 6.6% (2.3–12.9), hydrocele 6.5% (2.6–12.0). Antegrade embolization/sclerotherapy (403 cases): recurrence 7.6% (5.2–10.4), hydrocele 0.8% (0.17–1.9), technical failure 0.6% (0.1–1.6), complications 4.0% (2.3–6.1); retrograde embolization/sclerotherapy (509 cases): recurrence 6.9% (4.6–9.5), hydrocele 0.8% (0.05–2.5), technical failure 10.2% (4.6–17.6), and complications 4.8% (1.0–11.2). Conclusion: The recurrence rate varies between 2.1% and 7.6% and is higher with the embolization/sclerotherapy techniques. Post-operative hydrocele rate varies between 0.8% and 11.4% and is higher with the laparoscopic mass-ligation/division technique. Testicular atrophy has not been reported with the laparoscopic and embolization/sclerotherapy techniques. The retrograde embolization technique is associated with 10% technical failure (inability to complete the procedure). The laparoscopic lymphatic-sparing technique is characterized by the lowest recurrence rate, incidence of hydrocele and other complications, and no reports of testicular atrophy.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Therapeutic Advances In Urologymentioning

confidence: 99%

See 2 more Smart Citations

Outcome following the surgical management of varicocele in children and adolescents: a systematic review and meta-analysis

Tandon,

Bennett,

Mark Nataraja

et al. 2023

Therapeutic Advances in Urology

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“…A common and effective nonsurgical option is percutaneous embolization of the ISV, which has the advantages such as minimal invasiveness, lower cost, shorter recovery time, and decreased rates of adverse events. [7][8][9] In fact, a meta-analysis by Liu et al recently showed that patients undergoing endovascular treatment had fewer complications than patients undergoing surgery while maintaining comparable procedure outcomes. 10 Complications such as testicular pain and atrophy are markedly decreased due to the decreased risk of testicular artery damage, making it a safe and effective treatment option.…”

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confidence: 99%