Improvement of semen parameters after coil embolization of varicoceles: a systematic review

Belczak, Sérgio Quilici; Stefaniak, Vanessa; Góes, Leonardo Garcia; Neto, Felipe Coelho; Araújo, Walter Junior Boim de; Silva, Nathalia Almeida Cardoso da

doi:10.1590/1677-5449.200137

Cited by 2 publications

(5 citation statements)

References 26 publications

(66 reference statements)

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“…We took the opportunity of a 14 percutaneous embolization of varicocoele has been widely evolved and introduced in clinical practice, due to its minimally invasive nature and excellent clinical outcomes. 3,6,7,15 This procedure offers a rapid recov-ery and can be successfully accomplished in approximately 90% of attempts. 6 Various studies have demonstrated improvement in semen variables following embolization 15 ; moreover, percutaneous embolization is a viable treatment option for men suffering from orchalgia sec- and showed that at 39 months follow-up, 86.9% of patients had complete resolution of symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…We took the opportunity of a local policy change in the strategy of embolization to address this aspect. Since the first description in 1978 by Lima et al., 14 percutaneous embolization of varicocoele has been widely evolved and introduced in clinical practice, due to its minimally invasive nature and excellent clinical outcomes 3,6,7,15 . This procedure offers a rapid recovery and can be successfully accomplished in approximately 90% of attempts 6 .…”

Section: Discussionmentioning

confidence: 99%

“…3,6,7,15 This procedure offers a rapid recov-ery and can be successfully accomplished in approximately 90% of attempts. 6 Various studies have demonstrated improvement in semen variables following embolization 15 ; moreover, percutaneous embolization is a viable treatment option for men suffering from orchalgia sec- and showed that at 39 months follow-up, 86.9% of patients had complete resolution of symptoms. 16 Concerning varicocoele recurrence, most of surgical failures result from undiagnosed gonadal vein duplications.…”

Section: Discussionmentioning

confidence: 99%

“… 3 , 6 , 7 , 15 This procedure offers a rapid recovery and can be successfully accomplished in approximately 90% of attempts. 6 Various studies have demonstrated improvement in semen variables following embolization 15 ; moreover, percutaneous embolization is a viable treatment option for men suffering from orchalgia secondary to varicocoele. For instance, Puche–Sanz et al.…”

Section: Discussionmentioning

confidence: 99%

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Varicocoele embolization with sclerosing agents leads to lower radiation exposure and procedural costs than coils: Data from a real‐life before and after study

et al. 2022

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Objectives: To investigate clinical outcomes, radiation exposure and procedural costs associated with percutaneous varicocoele embolization using coils and sclerosing agents (SAs) in a cohort of young-adult men. Materials and methods: Data from consecutive men treated with percutaneous varicocoele embolization using coils and SA between 2017 and 2021 were analyzed. The allocation was based on a change of policy occurred in June 2020 with the substitution of coils with SA (before and after study). Semen analysis values were based on 2010 WHO reference criteria. Anatomic variants of gonadal veins were categorized according to Jargiello et al. Intraoperative radiation dose and procedural costs were collected for each patient. Descriptive statistics and linear regression models were used to describe the association between clinical parameters with procedural costs and radiation exposure.Results: One hundred sixteen men were included, of whom 76 (65.5%) received coils, and 40 (34.5%) received SA. Baseline characteristics of the two study groups did not differ. A type 3 Jargiello anatomic variation of left gonadal vein was found in 45.7% of cases. Radiation dose was lower in the SA group as compared to the coils one (13.2 [7-43] vs. 19.8 [12-57] Gy/cm 2 ; p < 0.001). Similarly, procedural costs were lower for the SA group (169.6 [169-199] € vs. 642.5 [561-775] €; p < 0.001). At follow-up, pain and sperm variables significantly improved in both groups (p < 0.01), without differences among the embolic materials. Linear regression model revealed that coils use was associated with higher radiation exposure (beta 8.8, p = 0.02) than SA after accounting for anatomic variation of gonadal vein, body mass index, and vascular access.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Varicocoele embolization with sclerosing agents leads to lower radiation exposure and procedural costs than coils: Data from a real‐life before and after study

et al. 2022

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“…[10] Hypertonic glucose 75% is considered a safe sclerosing agent. [11,12] Complications include edema, short-term local urticaria (15 minutes), transient glycemic elevation in patients with insulin resistance, and short-term neurological alteration (2 hours) in patients with migraines and arrhythmias. [11] Still, it has a high solute concentration, promotes the disintegration of the cells of the endothelial layer, and causes destruction and disintegration of the venous layer, which has a sclerosing effect on the walls of blood vessels.…”

Section: Introductionmentioning

confidence: 99%

Hypertonic glucose in the treatment of low back pain: A randomized clinical trial

Pereira Pires,

Rey Moura,

Oliveira

et al. 2023

Medicine

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Background: Chronic low back pain (LBP) is defined as pain lasting longer than 3 months and is one of the conditions with the most significant social impact. Treatment is complex and includes proliferative agents used in prolotherapy. The mechanism is not known, but osmotic agents (hypertonic solutions of dextrose or glucose) cause cellular rupture and an inflammatory response that releases cytokines and growth factors that lead to scarring and reinnervation. Methods: Patients with chronic LBP (>12 weeks) who were non-traumatic and unresponsive to at least 1 month of physical therapy were selected. All patients were followed up at a return visit at 1, 3, and 6 months for pain assessment using validated pain questionnaires and scales. Results: Nineteen patients were included in the conservative group and 19 in the glucose group, with the majority being women (57.9%). The patients were between 47 and 59 years of age (39.5%), mixed race (76.33%), married or in a committed relationship (73.7%), and had completed the study for 5.2 years. Overall mean body mass index was 27.3 ± 4.4 kg/m2 and was higher in the conservative group (28.0 ± 4.7 kg/m2). The groups showed differences in Visual Analog Scale scores, with median and amplitude values close to each other between the time points evaluated and increasing values in the glucose group, which had significantly higher values for this scale at the third evaluation (P = .031). When comparing the Rolland-Morris scale scores between the groups, there was a significant difference only in the 3-m assessment (P = .021). In the follow-up assessment, both groups showed significant improvement between T0 and the other assessment time points (P < .05) in all evaluations. Conclusion: Both groups significantly improved on the evaluated scales during follow-up. Overall, no effects were attributable to the glucose components or the prolotherapy protocol.

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Improvement of semen parameters after coil embolization of varicoceles: a systematic review

Cited by 2 publications

References 26 publications

Varicocoele embolization with sclerosing agents leads to lower radiation exposure and procedural costs than coils: Data from a real‐life before and after study

Varicocoele embolization with sclerosing agents leads to lower radiation exposure and procedural costs than coils: Data from a real‐life before and after study

Hypertonic glucose in the treatment of low back pain: A randomized clinical trial

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