MP30-17 A COMPARATIVE ANALYSIS OF EMBOLIZATION VERSUS SURGICAL MANAGEMENT OF VARICOCELE IN THE PROVINCE OF ONTARIO: A POPULATION-BASED STUDY

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP30-17 A COMPARATIVE ANALYSIS OF EMBOLIZATION VERSUS SURGICAL MANAGEMENT OF VARICOCELE IN THE PROVINCE OF ONTARIO: A POPULATION-BASED STUDY Aidan Canil, Wenbin Li, Kingston Canada, Premal Patel, Winnipeg Canada, Ben Mussari, Timothy Hanna, D. Robert Siemens, and R. Christopher Doiron Aidan CanilAidan Canil More articles by this author , Wenbin LiWenbin Li More articles by this author , Kingston CanadaKingston Canada More articles by this author , Premal PatelPremal Patel More articles by this author , Winnipeg CanadaWinnipeg Canada More articles by this author , Ben MussariBen Mussari More articles by this author , Timothy HannaTimothy Hanna More articles by this author , D. Robert SiemensD. Robert Siemens More articles by this author , and R. Christopher DoironR. Christopher Doiron More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003258.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The optimal approach for management of varicocele is currently unknown. Existing evidence is of low quality with no randomized controlled studies comparing approaches. We provide the first population-based analysis of embolization vs surgical management of varicocele. METHODS: All patients in the province of Ontario who underwent treatment of their varicocele between April 1, 2002-March 31, 2012 were identified using ICES databases. The index intervention was considered the approach first used in the treatment-naïve patient – open surgery or embolization. The primary outcome was the rate of reintervention while secondary outcomes included complications and healthcare utilization. RESULTS: We identified 557,650 male patients with a varicocele diagnosis, of whom n=3,180 underwent an intervention and were included in the study – n=2,139(67%) underwent open varicocelectomy while n=1,041(33%) underwent embolization as their index intervention (Figure 1). Reintervention was more common amongst those who underwent embolization compared to those who underwent surgical management [n=97(9.3%) vs n=142(6.6%);p<0.01]. While controlling for demographics, regression analysis showed surgical varicocelectomy was still less likely to require reintervention [OR 0.68(0.52-0.90);p<0.01].Those who underwent surgical management had higher rates of complications requiring ED visits within 1 month of the procedure. This association was persistent on regression analysis, controlling for demographics [OR 1.69(1.27-2.25);p<0.01]. There was no difference in hospital admissions between the groups [OR 1.53(0.94-2.49);p=0.087].There was a weak association between socioeconomic status (SES) and type of index intervention with the least wealthy income quintile more likely to receive surgery [OR 1.27(1.01-1.60);p=0.04] while there was no difference based on rurality and age. CONCLUSIONS: This first population-based study to examine surgical management vs embolization for treatment of varicocele shows that surgery is less likely to require repeat intervention but with a modest increased risk of complications. Source of Funding: NA © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e397 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Aidan Canil More articles by this author Wenbin Li More articles by this author Kingston Canada More articles by this author Premal Patel More articles by this author Winnipeg Canada More articles by this author Ben Mussari More articles by this author Timothy Hanna More articles by this author D. Robert Siemens More articles by this author R. Christopher Doiron More articles by this author Expand All Advertisement PDF downloadLoading ...