Endovascular management of testicular varicoceles (CME) – online course
Authors: G. Makris and R. Uberoi
Reviewers: F. Deschamps, M. Deutschmann, F. Fanelli, M. Hoffmann and C. Nice
This course corresponds to chapter 220.127.116.11.5 Gonadal Venous Interventions in the European Curriculum and Syllabus for IR.
Varicoceles are abnormal dilatations of the pampiniform venous plexus draining the testicles. The incidence of varicoceles in normal healthy males is estimated to be 8-23%, with the majority of cases affecting the left side. The aetiology of the majority of varicoceles is unknown, but upstream obstructive causes should be sought. They are often asymptomatic, but may be associated with aching discomfort and infertility. Surgery has been used to treat varicoceles for over a century but over the last few decades, radiological techniques have become increasingly popular as a less invasive technique. Initially this was used where surgery had failed, but has now become the primary technique in the treatment of varicoceles.
Percutaneous embolisation was first described in 1978 by Lima et al. and subsequently many case series have been published demonstrating the safety and efficacy of this technique, especially in improving sperm count values, successful pregnancy and the improvement in pain symptoms. Interventional treatment as minimally invasive treatment offers significant advantages over surgery with less patient discomfort, rapid recovery and a relatively simple day-case procedure.
A variety of embolic agents are available for varicocele embolisation, including mechanically occlusive solid agents such as coils and plugs, as well as liquid embolic agents including sclerosants and glue, with similar reported outcomes.
- Understand the relevant anatomy
- Understand the indications and contraindications of the technique
- Achieve a basic understanding of the embolisation technique for the testicular varices
- Understand the benefits and limitations of the various embolic materials
This course covers a basic level of IR knowledge and is designed for trainees, students or young consultants aiming to acquire essential knowledge or prepare for the EBIR exam. Thereby, it is tailored to the European Curriculum and Syllabus for IR and corresponds to chapter 18.104.22.168.5 Gonadal Venous Interventions.
The format of the course is interactive and easy to use, including texts, graphics, videos and a quiz to support your learning. The course duration is around one hour and is accredited by the European Accreditation Council for Continuing Medical Education (EACCME) to award 1 European CME credit (ECMEC). The CME accreditation for this course will expire on March 19, 2021. A non-CME accredited version of the course will remain available until the new CME accredited course is published.
Upon purchase, access to complete and revisit the course is granted for an enrolment period of 90 days.
The CME certificate will be available in the myCIRSE area past the enrolment period if the course is completed before March 19, 2021.
Release date: March 2019