Varicocele, conventional laparoscopic ligation versus occluding balloon embolization

  • Alessandro MottaEmail author
  • Giuseppe Caltabiano
  • Marco Pizzarelli
  • Giovanni Failla
  • Dragos Botezatu
  • Horia Muresanu
  • Pietro Foti
  • Sandro La Vignera
  • Rosita Condorelli
  • Stefano Palmucci
  • Antonio Basile



Varicocele is a relatively complex pathology that affects the pampiniform plexus of veins in the spermatic cord. Modern treatment involves both urological/surgical and interventional procedures. Our objective is to compare outcomes of conventional laparoscopic ligation (LL) and occluding balloon embolization (OBE) a percutaneous interventional procedure.

Materials and methods

We treated retrospectively a total of 98 patients, divided in two cohorts; arm A with 48 and arm B with 50 patients. Arm A patients underwent LL, while arm B ones were treated in interventional radiology suite, via OBE method. No comorbidities were reported, especially scrotal ones. Hence, all patients have been asked to respect 3 and 6 months’ follow-up, clinical examination and ultrasonography were performed. Age range of the entire sample: 15–45 years old, with average of 28 years. The study involved two European centers. We performed a comparative analysis (Fisher’s test) of intra-operative time, hospitalization and patient’s postoperative recovery time.

Results and limitations

Outcomes have been in line with the recent literature ones, allowing the occluding balloon embolization a small advantage for quicker operative average time, hospitalization needed and full recovery to normal activities for the patient. Main limitation was the unfeasibility of cost-effectiveness analysis due to national differences, limited sample and lack of complete semen analysis pre- and postoperative.


Both OBE and LL are safe and effective procedures in the treatment of varicocele, conceding OBE a slight advantage in terms of hospital stay and full recovery to normal activity of patients.


Varicocele Laparoscopic ligation Occluding balloon Embolization Interventional radiology 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Italian Society of Medical Radiology 2019

Authors and Affiliations

  • Alessandro Motta
    • 1
    Email author
  • Giuseppe Caltabiano
    • 1
  • Marco Pizzarelli
    • 1
  • Giovanni Failla
    • 2
  • Dragos Botezatu
    • 3
  • Horia Muresanu
    • 3
  • Pietro Foti
    • 4
  • Sandro La Vignera
    • 4
  • Rosita Condorelli
    • 4
  • Stefano Palmucci
    • 4
  • Antonio Basile
    • 4
  1. 1.Department of Interventional Radiology“ARNAS” Garibaldi HospitalCataniaItaly
  2. 2.Diagnostica per Immagini e Radiologia InterventisticaAzienda Ospedaliera per l’Emergenza “Cannizzaro”CataniaItaly
  3. 3.Vasile Goldis Western UniversityAradRomania
  4. 4.Department of Radiology and Radiotherapy, Policlinico Universitario Gaspare RodolicoAzienda Ospedaliera Universitaria Policlinico Vittorio EmanueleCataniaItaly

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