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. 2023 Jan 18;12(3):755.
doi: 10.3390/jcm12030755.

Radiation Exposure and Surgical Outcomes after Antegrade Sclerotherapy for the Treatment of Varicocele in the Paediatric Population: A Single Centre Experience

Carolina Bebi  1 , Marco Bilato  1 , Dario Guido Minoli  1 , Erika Adalgisa De Marco  1 , Michele Gnech  1 , Irene Paraboschi  1 , Luca Boeri  2 , Irene Fulgheri  3 , Roberto Brambilla  4 , Mauro Campoleoni  4 , Giancarlo Albo  2   5 , Emanuele Montanari  2   5 , Gianantonio Manzoni  1 , Alfredo Berrettini  1
Affiliations

Radiation Exposure and Surgical Outcomes after Antegrade Sclerotherapy for the Treatment of Varicocele in the Paediatric Population: A Single Centre Experience

Carolina Bebi et al. J Clin Med. .

Abstract

Introduction: Antegrade sclerotherapy (Tauber) effectively treats varicocele. However, fluoroscopy exposes young males to ionizing radiation. We aimed to evaluate radiation exposure and surgical outcomes after the Tauber procedure.

Materials and methods: We retrospectively analysed data from 251 patients. Dose area product (DAP) and fluoroscopy time were recorded. The effective dose was calculated with the PCXMC software. Descriptive statistics and linear regression tested the association between clinical predictors and radiation exposure.

Results: Median (IQR) age and body mass index (BMI) were 14 (13-16) years and 20.1 (17.9-21.6) kg/m². Five (2.1%) patients developed clinical recurrence and two (0.81%) developed complications. Median fluoroscopy time and DAP were 38.5 (27.7-54.0) s and 89.6 (62.5-143.9) cGy*cm2. The effective dose was 0.19 (0.14-0.31) mSv. Fluoroscopy time was higher in patients with collateral veins (41 (26-49) s vs. 36 (31-61) s, p = 0.02). The median amount of sclerosing agent (SA) used was 3 (3-4) ml. DAP was higher when SA > 3 mL was used (101.4 (65-183) cGy*cm2 vs. 80.5 (59-119) cGy*cm2; p < 0.01). At univariable linear regression, age, BMI, operative time and SA > 3 mL were associated with higher DAP (all p < 0.01). At multivariable linear regression, only BMI (beta 12.9, p < 0.001) and operative time (beta 1.9, p < 0.01) emerged as predictors of higher DAP, after accounting for age and SA > 3 mL.

Conclusions: The Tauber procedure is safe and associated with low effective doses. Operative time and the patient's BMI independently predict a higher radiation dose.

Keywords: Tauber procedure; antegrade sclerotherapy; fluoroscopy; male infertility; paediatric varicocele; radiation exposure; varicocele.

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Conflict of interest statement

The authors declare no conflict of interest.

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