The World Journal of Men's Health (Jul 2021)

Practice Pattern of Redo Varicocelectomy for Recurrent Varicocele according to Type of Initial Treatment: Retrospective Analysis of a United States-Based Insurance Claims Database

  • Hyoung Keun Park,
  • Gyeong Eun Min,
  • Kyung Jin Chung,
  • Shufeng Li,
  • Woo Suk Choi,
  • Benjamin I. Chung

DOI
https://doi.org/10.5534/wjmh.190170
Journal volume & issue
Vol. 39, no. 3
pp. 559 – 565

Abstract

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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: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 De-cember 2014 using International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) codes. The treat-ment methods were identified by Current Procedural Terminology (CPT) code. Results: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 ingui-nal, 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: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.

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