World J Mens Health.
2021 Jul;39(3):559-565. 10.5534/wjmh.190170.
Practice Pattern of Redo Varicocelectomy for Recurrent Varicocele according to Type of Initial Treatment: Retrospective Analysis of a United States-Based Insurance Claims Database
- Affiliations
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- 1Department of Urology, Stanford University Medical Center, Stanford, CA, USA
- 2Department of Urology, Konkuk University School of Medicine, Seoul, Korea
- 3Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea
- 4Department of Urology, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
- 5Department of Dermatology, Stanford University Medical Center, Stanford, CA, USA
- KMID: 2516722
- DOI: http://doi.org/10.5534/wjmh.190170
Abstract
- Purpose
The objective of this study was to investigate the type of redo varicocelectomy according to the initial surgery type using a large population of USA insurance data.
Materials and Methods
This is a retrospective observational cohort study. Administrative claims data were extracted from the IBM® MarketScan Research Database. We included all newly diagnosed patients with varicocele from January 2007 to December 2014 using International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) codes. The treatment methods were identified by Current Procedural Terminology (CPT) code.
Results
A total of 261,785 subjects were diagnosed with varicocele. Of these, a total of 19,800 (7.6%) patients underwent varicocele surgery. Inguinal, abdominal, laparoscopic, microsurgery, and embolization surgery were performed in 66%, 19%, 10%, 3%, and 2%, respectively, as initial treatment. A total of 340 patients (1.7%) underwent redo varicocele surgery. Inguinal, microscopic, embolization, abdominal, and laparoscopic surgery were used as the redo method in 43%, 25%, 16%, 8%, and 7%, respectively. The redo inguinal approach was the preferred method in patients who first underwent inguinal, abdominal, and laparoscopic surgery, but not in patients who underwent microscopic or embolization procedures. Most patients who initially underwent microscopic varicocelectomy or embolization underwent redo varicocelectomy using the same method.
Conclusions
Compared to the type of initial varicocelectomy, there were changes in the proportion of each type of surgical approach in redo operation procedures. While inguinal varicocelectomy is the most common method in redo operations, the number of microscopic varicocelectomy or embolization procedures is significantly increased in redo surgery.
