1933 VARICOCELE SURGERY OR EMBOLIZATION: WHICH IS BETTER? IT DEPENDS ON WHOSE SIDE YOU ARE ON
Notice bibliographique
Résumé
You have accessJournal of UrologyInfertility: Therapy/Evaluation1 Apr 20101933 VARICOCELE SURGERY OR EMBOLIZATION: WHICH IS BETTER? IT DEPENDS ON WHOSE SIDE YOU ARE ON Darby Cassidy, Dimitre Ranev, Cori Caughlin, Kirk Lo, Ethan Grober, Rob Beecroft, and Keith Jarvi Darby CassidyDarby Cassidy More articles by this author , Dimitre RanevDimitre Ranev More articles by this author , Cori CaughlinCori Caughlin More articles by this author , Kirk LoKirk Lo More articles by this author , Ethan GroberEthan Grober More articles by this author , Rob BeecroftRob Beecroft More articles by this author , and Keith JarviKeith Jarvi More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1901AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES A varicocele remains the most commonly identified correctable cause of male factor infertility. In North America, surgical correction is the most commonly performed technique to treat varicoceles with an expected technical failure rate of less than 5%. An alternative to surgery is selective catheterization and embolization of the gonadal vein using sclerosing agents, tissue adhesives, or detachable coils. The improvements in fertility following varicocele repair appear to be independent of the type of repair, as long as the repair was successful. Our objective was to the review the failure rates of varicocele embolization done for male factor infertility from our institution to determine if these rates were higher than expected with a surgical repair. METHODS Retrospective review of the University of Toronto varicocele database. All of the patients included in the database had clinical varicoceles with ultrasound confirmation. Patients with ultrasound evidence of a contralateral subclinical varicocele were offered bilateral varicocele embolization. RESULTS A total of 158 patients were identified from 2004 to 2008 who underwent embolization for clinical varicocele(s) and male factor infertility. 56% (88/158) underwent attempted bilateral embolization, 43% (68/158) unilateral left sided embolization, and 1.3% (2/158) unilateral right sided embolization. Of those patients who underwent attempted bilateral embolization, there was a 19.3% (17/88) technical failure rate in achieving successful obliteration of the right gonadal vein and a 2.3% (2/88) technical failure rate in the embolization of the left gonadal vein. Of the 2 attempts at unilateral right sided embolization there were no failures (0/2). Of 68 unilateral left sided embolization attempts there was a 4.4% failure rate (3/68). Of all of the right sided embolization attempts, 18.9% failed (17/90), while 3.2% (5/156) of the left sided attempts failed. CONCLUSIONS This review represents the largest contemporary series of varicocele embolization outcomes currently in the literature. Our 19.3% technical failure rate for bilateral varicocele embolization is higher than the current published rate of 13%. This was almost universally secondary to failure to access the right gonadal vein from the inferior vena cava. This supports our belief that bilateral varicoceles are best managed with a primary microsurgical approach where technical failure rates are expected to be less than 5% based on published data. Toronto, Canada© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e751 Peer Review Report Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Darby Cassidy More articles by this author Dimitre Ranev More articles by this author Cori Caughlin More articles by this author Kirk Lo More articles by this author Ethan Grober More articles by this author Rob Beecroft More articles by this author Keith Jarvi More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,218 | 0,061 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».