AB013. SOH25_AB_172. A decade of minimally invasive varicocele embolization: a new gold standard or complement to surgical varicocelectomy?
Urology Session

AB013. SOH25_AB_172. A decade of minimally invasive varicocele embolization: a new gold standard or complement to surgical varicocelectomy?

Amor Fadel Alkadhimi1, Meadhbh Ni Mhiochain de Grae1, Maha Al-Khattab2, Maïa Springael1, Gerry O’Sullivan2

1Department of Surgery, Tallaght University Hospital, Tallaght, Dublin, Ireland; 2Department of Radiology, University Hospital Galway, Galway, Ireland

Background: Varicoceles are vascular lesions of the pampiniform plexus, affecting 10–20% of the population and present in 40% of men with primary infertility and 80% with secondary infertility. Pain occurs in 2–10% of cases. Treatment options include conservative management, percutaneous embolization, or surgery. Percutaneous embolization has a technical failure rate of around 13% and recurrence rates of 0.6% to 45%, whilst surgical approach has a recurrence rate of around 4%. This study evaluates success and recurrence rates of percutaneous varicocele embolizations at University Hospital Galway and Galway Clinic between 2009–2022, with a minimum follow-up of 18 months.

Methods: Data collected included age, procedure date, access site, occurrence side, previous interventions, treatment method, reintervention need, and recurrence rates. Technical success was defined as successful gonadal vein access and insertion of coil/sclerosant. Clinical success was assessed through follow-up consultations and ultrasound when available.

Results: The technical success rate was 94.7%, with 98.1% of successful embolizations achieving clinical success. Of 225 patients, 3.12% had prior failed surgeries, all treated successfully with interventional radiology, and 0.89% required surgical intervention. Telephone follow-ups (42.7% response rate) revealed a 10.7% recurrence rate with an average follow-up of 8.03 years. Complication rate was 1.78%. Fertility outcomes showed 51.35% of patients had successful pregnancies, while 6.9% experienced ongoing fertility issues.

Conclusions: Our study of 225 patients is the largest to date, showing higher success rates (technical 94.7%, clinical 98.1%) and a 10.7% recurrence rate with long-term follow-up. However, the recurrence rate and the subset requiring surgery highlight the potential complementary role of surgical intervention.

Keywords: Varicocele embolization; percutaneous embolization; infertility treatment; varicocelectomy; varicocele

Acknowledgments

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Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab013
Cite this abstract as: Fadel Alkadhimi A, Ni Mhiochain de Grae M, Al-Khattab M, Springael M, O’Sullivan G. AB013. SOH25_AB_172. A decade of minimally invasive varicocele embolization: a new gold standard or complement to surgical varicocelectomy? Mesentery Peritoneum 2025;9:AB013.

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