Transbrachial approach to the treatment of uterine leiomyomas with embolization of the uterine arteries: a preliminary technical experience

Pieri, Stefano; Felice, Maurizio Di; Moreschi, Emilo; Damiani, Paul; Marasca, Edvige; Agresti, Paolo; Sessa, Barbara; Trinci, Margherita; Menichini, G; Giampietro, Ilenia Di; Miele, Vittorio

doi:10.1007/s11547-015-0498-0

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…Pieri et al reported that in a series of 1490 varicoceles the percutaneous retrograde sclerotherapy via the basilic vein was successful in only 79.2% of cases because in the remaining patients, there was a venous spasm during the introduction of the cannula, particularly in children. 79 We found an overall rate of technical failure of 10.2% with the retrograde technique, often due to difficult cannulation of the internal spermatic vein via the femoral vein in 10-20% of patients. 67,68 Finally, it must be noted that both the antegrade and retrograde techniques expose patients to radiation (including the testicles).…”

Section: Therapeutic Advances In Urologymentioning

confidence: 83%

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: Therapeutic Advances In Urologymentioning

confidence: 83%

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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“…In a recent report, UAE performed via a brachial approach was shown to be safe and technically valid, with ease of selective catheterization and without the need of catheter exchanges. This also may be better accepted by patients due to early ambulation, avoidance of bladder catheterization, and also a lower radiation dose (5).…”

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confidence: 99%

Successful Management of a Case of Refractory Prostatic Hematuria by Prostate Artery Embolization via a Brachial Artery Access

et al. 2016

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Urological complications of uterine leiomyoma: a review of literature

et al. 2016

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Leiomyoma is a common tumor of the uterus that often clinically impacts on the lower urinary tract and results in urological and sexual symptoms. Leiomyoma can compress and grow into and become adherent to the bladder and surrounding pelvic organs or metastasize into peritoneal organs. Leiomyoma can enlarge and compress the urinary bladder, urethra, and lower end of the ureters. Leiomyoma can cause embarrassing sexual dysfunction in females. Current literature of non-surgical and surgical therapy of leiomyoma is described.

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Transbrachial approach to the treatment of uterine leiomyomas with embolization of the uterine arteries: a preliminary technical experience

Cited by 3 publications

References 10 publications

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

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

Successful Management of a Case of Refractory Prostatic Hematuria by Prostate Artery Embolization via a Brachial Artery Access

Urological complications of uterine leiomyoma: a review of literature

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