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Войти в исследования Journal of pediatric urology · 2026
Analysis of short-term outcomes after antegrade sclerotherapy: A comparison of Tauber procedure variations in two pediatric centers.
СтатьяНазвание и аннотация: Перевод в очереди
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Fanti Federica, Gnech Michele, Alessandro Morlacco, Bianco Marta, Dal Moro Fabrizio, Beltrami Paolo, Rotondi Giulia, Ciamarra Fabio, De Marco Erika, Roggero Arianna, Minoli Dario Guido, Thomas Eduje, Marceca Federica, Berrettini Alfredo
Аннотация
INTRODUCTION: Antegrade scrotal sclerotherapy is a simple and effective technique for the treatment of pediatric varicocele. Since its first description by Tauber et al., in 1988, several technical modifications have been introduced. However, comparative data on the outcomes of these variations in pediatric populations remain limited.
AIM: To compare surgical outcomes of antegrade scrotal sclerotherapy performed with different variations of the original technique in two pediatric urology centres.
METHODS: We retrospectively analysed 275 patients under 18 years of age treated for varicocele between April 2010 and November 2022 at the Pediatric Urology Departments of IRCCS Ca' Granda of Milan, Italy (n = 178) and at the Department of Pediatric Urology of the AOPD of Padua, Italy (n = 97). The two centers adopted variations in anesthesia (general vs local), vessel isolation (single dilated vessel vs isolation of the entire spermatic cord except the vas deferens), and embolization technique (foam sclerosing agent vs "air-block" method with 1 mL air followed by 4 mL sclerosant during a Valsalva maneuver). Descriptive statistics were calculated using R v1.2.5042. Pearson's χ2 test or Fisher's exact test were used as appropriate, with statistical significance set at p < 0.05. Primary outcomes were recurrence rate and short-term postoperative complications. Secondary outcomes were operative time and anesthesia type.
RESULTS: Mean patient age was 14.2 years (range 7-17), with a mean follow-up of 7.3 months. Recurrence was significantly higher at the Padua centre (p = 0.006), while complication rates did not differ between centers (p = 0.56). Operative time was slightly shorter with the Padua technique (31.6 min vs 35.5 min, p = 0.009).
CONCLUSION: Antegrade scrotal sclerotherapy remains an effective and safe technique for pediatric varicocele treatment. Technical variations and anesthesia choice may influence recurrence rates. Broader collaborative data collection across pediatric centers is essential to establish evidence-based recommendations and reduce variability in surgical practice.
AIM: To compare surgical outcomes of antegrade scrotal sclerotherapy performed with different variations of the original technique in two pediatric urology centres.
METHODS: We retrospectively analysed 275 patients under 18 years of age treated for varicocele between April 2010 and November 2022 at the Pediatric Urology Departments of IRCCS Ca' Granda of Milan, Italy (n = 178) and at the Department of Pediatric Urology of the AOPD of Padua, Italy (n = 97). The two centers adopted variations in anesthesia (general vs local), vessel isolation (single dilated vessel vs isolation of the entire spermatic cord except the vas deferens), and embolization technique (foam sclerosing agent vs "air-block" method with 1 mL air followed by 4 mL sclerosant during a Valsalva maneuver). Descriptive statistics were calculated using R v1.2.5042. Pearson's χ2 test or Fisher's exact test were used as appropriate, with statistical significance set at p < 0.05. Primary outcomes were recurrence rate and short-term postoperative complications. Secondary outcomes were operative time and anesthesia type.
RESULTS: Mean patient age was 14.2 years (range 7-17), with a mean follow-up of 7.3 months. Recurrence was significantly higher at the Padua centre (p = 0.006), while complication rates did not differ between centers (p = 0.56). Operative time was slightly shorter with the Padua technique (31.6 min vs 35.5 min, p = 0.009).
CONCLUSION: Antegrade scrotal sclerotherapy remains an effective and safe technique for pediatric varicocele treatment. Technical variations and anesthesia choice may influence recurrence rates. Broader collaborative data collection across pediatric centers is essential to establish evidence-based recommendations and reduce variability in surgical practice.