Friday 14 October 2016

Abstract

Purpose: Varicocele (abnormal dilatation of the pampiniform plexus secondary to a defect in the venous renospermatic system) is a relatively common condition, affecting 8-23% of young healthy males (1). Though often benign, it may create problems (significant pain in 14% or male factor infertility) that warrant intervention (1). Options for treatment are broadly classified into surgical or radiological (2). We aimed to determine the efficacy of radiological embolisation for the treatment of varicoceles by a single interventional radiology unit. Materials and methods: A retrospective review of all varicocele embolisation procedures performed by the interventional radiology unit at Austin Hospital (Melbourne) for the period of July 2005 to June 2015 was performed. Records and details (demographics, side, indication, duration, length of coil, complications) were obtained from electronic databases. Follow-up data was collected from the referring urologists. Results: A total of 131 varicocele embolisation procedures were performed. The majority of patients 105/131 (80%) were less than 40 years of age. Major indications were symptomatic pain (69%) or subfertility (10%). Laterality was 127/131 (97%) for left and 4/131 (3.1%) for bilateral varicoceles. Total coil length ranged from 18 to 38 mm. Procedure lengths averaged at 45mins. Complication rate was 6.1%, and mostly minor and not resulting in procedural abandonment. Complete follow-up data was obtained for 83patients only. Of these, recurrence occurred in only five patients (6.0%). Conclusions: Our study demonstrates that radiological embolisation is an effective modality for the treatment of varicoceles. Our single centre experience demonstrates comparable complication and recurrence rates of radiological embolisation versus the surgical treatment options (3). Given radiological embolisation is a day procedure with a reasonably short procedure time; our findings make it an effective option comparable to surgery. Objective / Introduction: Radiography of the immature skeleton is complex for junior doctors and students due to physes and ossification centers. Knowledge of normal radiographic characteristics is important to interpretation, which form the majority of xray studies of the paediatric population. Books and image based resources such as Keats Atlas of Normal Variants are cumbersome as an introductory resource, and a video/timelapse approach to normal skeletal development would condense the knowledge to a more accessible form. Project objective is to improve JMO proficiency in reading paediatric radiographs, including familiarity with the order of appearance of ossification centers, and improved fracture detection accuracy. Methods and materials:To demonstrate feasibility, a test timelapse was completed for the pelvis and proximal femur for 0-10 years of age. Anonymised radiographs were obtained from the local radiology department PACS. Images were aligned and stacked in a video editor, and annotated the order of appearance of ossification centres and physeal...