Management of paediatric varicocele in Australia and New Zealand: A survey of the Australian and New Zealand association of paediatric surgeons (ANZAPS).

IF 1.9 3区医学 Q2 PEDIATRICS

Journal of Pediatric Urology Pub Date : 2025-09-13 DOI:10.1016/j.jpurol.2025.09.006

Tanay Bapna, Sarthak Tandon, Craig A McBride, Udaya Samarakkody, Kiarash Taghavi, Ramesh M Nataraja, Maurizio Pacilli

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引用次数: 0

Abstract

Purpose: The diagnosis and management of paediatric varicocele remain controversial. We aimed to evaluate current practices in Australia and New Zealand (ANZ).

Methods: An anonymous survey using the online Qualtrics platform (© 2024 Qualtrics), distributed to 114 ANZ active paediatric surgeons and paediatric urologists. Data collected included demographics, diagnostic processes, operative indications and techniques, and post-operative follow-up. Descriptive statistical analysis was conducted.

Results: A total of 61 (53 %) responses were collected. The most commonly used diagnostic method was clinical examination with ultrasound (63% of respondents), with 82 % of this group requesting ultrasounds of the testes and abdomen. The principal indications for surgery were testicular volume discrepancies (95 % of respondents) and patient discomfort (97 %). A laparoscopic method was the first-line surgical approach for 51 % of respondents, interventional radiology (IR) for 45 %, and an open approach for 4 %. Mass ligation was the most common laparoscopic technique (74 %), with metallic clips used by 52 %. The majority of respondents favouring IR deferred to interventional radiologists regarding specific approaches. Most respondents (76 %) reported following-up patients for 1-2 years post-operatively.

Conclusion: We have identified consistent practices among ANZ surgeons regarding the clinical assessment and indications for intervention. Differences are noted with the operative management, with a clear divide between a laparoscopic approach and radiological approach; this may reflect institutional expertise and pathways. This survey forms the basis for collaborative research to standardise the diagnosis and management of paediatric varicocele.

Level of evidence: Level 5.

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澳大利亚和新西兰儿科精索静脉曲张的管理：澳大利亚和新西兰儿科外科医生协会（ANZAPS）的一项调查。

目的：小儿精索静脉曲张的诊断和治疗仍有争议。我们旨在评估澳大利亚和新西兰（ANZ）的现行做法。方法：使用在线Qualtrics平台（©2024 Qualtrics）进行匿名调查，分发给114名澳新银行活跃的儿科外科医生和儿科泌尿科医生。收集的数据包括人口统计学、诊断过程、手术指征和技术以及术后随访。进行描述性统计分析。结果：共收集61例（53%）问卷。最常用的诊断方法是临床超声检查（63%的受访者），其中82%的人要求对睾丸和腹部进行超声检查。手术的主要指征是睾丸体积差异（95%的应答者）和患者不适（97%）。腹腔镜方法是51%的应答者的一线手术入路，介入放射学（IR）占45%，开放入路占4%。大块结扎是最常见的腹腔镜技术（74%），金属夹是52%。在具体的治疗方法上，大多数支持IR的应答者向介入放射科医生咨询。大多数应答者（76%）报告患者术后随访1-2年。结论：我们已经确定了ANZ外科医生关于临床评估和干预指征的一致做法。不同之处在于手术处理，在腹腔镜入路和放射入路之间有明确的区分；这可能反映了机构的专业知识和途径。这项调查形成了合作研究的基础，以标准化的诊断和管理的儿科精索静脉曲张。证据等级：5级。

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来源期刊

Journal of Pediatric Urology PEDIATRICS-UROLOGY & NEPHROLOGY

CiteScore

3.70

自引率

15.00%

发文量

330

审稿时长

4-8 weeks

期刊介绍： The Journal of Pediatric Urology publishes submitted research and clinical articles relating to Pediatric Urology which have been accepted after adequate peer review. It publishes regular articles that have been submitted after invitation, that cover the curriculum of Pediatric Urology, and enable trainee surgeons to attain theoretical competence of the sub-specialty. It publishes regular reviews of pediatric urological articles appearing in other journals. It publishes invited review articles by recognised experts on modern or controversial aspects of the sub-specialty. It enables any affiliated society to advertise society events or information in the journal without charge and will publish abstracts of papers to be read at society meetings.