Evidence map›Paper›PMID 41137990›Full record

SynthesisWorld journal of urology2025

Comparison of sclero-embolization and surgical ligation for varicocele treatment: a systematic review and meta-analysis.

Huiling Chen, Kun Liu, Ming Liu, Tao Jin, Liang Zhou

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Publisher
In one paragraph

Synthesis in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Huiling ChenDepartment of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Kun LiuDepartment of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Ming LiuNational Center of Gerontology, Institute of Geriatric Medicine, Beijing Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Tao JinDepartment of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Liang ZhouDepartment of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China. zhouliang1990@scu.edu.cn.ORCID http://orcid.org/0000-0003-3439-0222

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesVaricocele is characterized by abnormally dilated and tortuous veins in the pampiniform plexus. Treatment options are varied, including open surgery, laparoscopic surgery, microscopic varicocelectomy, and sclero-embolization. However, no consensus exists on the optimal treatment. This systematic review and meta-analysis aim to compare the effectiveness and safety of sclero-embolization versus surgical ligation for varicocele.

methodsIn accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically searched PubMed, Web of Science, EMBASE, and MEDLINE for relevant studies up to October 14, 2023. Study selection followed the Patient, Intervention, Comparison, Outcome, Study type (PICOS) framework. The quality of included studies was assessed using the Newcastle-Ottawa Scale (NOS) for cohort studies and the Cochrane Risk of Bias Tool (CCTARB) for randomized controlled trials. Data analysis was performed using Review Manager (RevMan) version 5.4.

resultsThirty studies were included in the final analysis. Regarding recurrence rates, sclero-embolization was associated with a statistically higher recurrence rate compared to high ligation (OR = 1.37, 95% CI 1.03-1.82, p = 0.03). For sperm concentration, a non-significant trend favoring sclero-embolization was observed (MD = 7.09, 95% CI -0.14 to 14.31, p = 0.05). Sclero-embolization demonstrated a more favorable safety profile, with lower overall complication rates (OR = 0.65, 95% CI 0.47-0.91, p = 0.01) and significantly reduced incidence of hydrocele (OR = 0.19, 95% CI 0.10-0.35, p < 0.00001) compared to surgical ligation.

conclusionThis meta-analysis reveals a nuanced trade-off between sclero-embolization and surgical ligation for varicocele treatment. Sclero-embolization is associated with higher recurrence rates but a more favorable safety profile, while its effect on sperm concentration remains marginal and inconclusive. Surgical ligation, particularly the high ligation approach, demonstrates superior efficacy in preventing recurrence but carries a higher risk of complications. The choice of technique should therefore be individualized based on patient-specific factors. These findings warrant validation through further high-quality, prospective studies.

Indexed as

Embolization, TherapeuticSclerotherapyVaricoceleHumansLigationMaleTreatment OutcomeUrologic Surgical Procedures, MaleEfficacyEmbolizationSafetySclero-embolizationSurgical ligationVaricocele

Identifiers

PMID41137990

What OpenQuestion holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.