Treatment of Varicocele in Adults: Surgery versus Embolization: Experience of Mohammed V Military Instruction Hospital

Abstract

Introduction: Varicocele is a varicose dilatation of the spermatic cord veins, particularly the pampiniform plexus. It is a frequent and benign affection, which may have a harmful effect on spermatogenesis. Aim: Through this work, we will try to compare the efficiency, complications and recurrence after treatment of varicocele in two patients groups: surgery and embolization. Material and Methods: This is a retrospective study that included all patients treated for idiopathic varicocele, symptomatic or associated with abnormalities of the semen analysis, by embolization, between 2016 and 2021, at the Moulay Ismail Military Instruction Hospital. Thirty patients were included. To compare, the last 30 patients treated by surgery (open or laparoscopic) were included in a second group. Patients in the embolization group were treated with coil embolization or sclerosant agent under local anesthesia. We compared the efficiency, complications and recurrence rate after treatment of varicocele in both groups. The statistical analysis was carried out by the epidemiology laboratory of the Faculty of Medicine and Pharmacy of Fes using the Chi test 2 and Anova test. Results: Surgery has a higher success rate than embolization. However, embolization offers many advantages in terms of surgical time (p = 0.001), duration of hospital stay (p = 0.001), lower recovery time, and less long-term complications. Recurrence was found in 4 patients in group 1 and in 2 patients in group 2. In both groups, there was an improvement in semen analysis, with pregnancy occurred in one couple in group 2, and four in group 1. Conclusion: These two treatment methods are effective in the treatment of idiopathic varicocele, but embolization is a faster, less invasive technique with low postoperative morbidity.