Yonsei Med J.  2012 Jan;53(1):145-150. 10.3349/ymj.2012.53.1.145.

Microsurgical Ligation for Painful Varicocele: Effectiveness and Predictors of Pain Resolution

• Kim HT
• Song PH
• Moon KH

• KMID: 1779699
• DOI: http://doi.org/10.3349/ymj.2012.53.1.145

Abstract

PURPOSE
We evaluated the effectiveness of microsurgical ligation for painful varicocele and predictive factors of pain resolution.
MATERIALS AND METHODS
Between January 2006 and March 2009, a total of 114 patients (mean age, 30.2+/-8.9 years), who underwent microsurgical inguinal varicocelectomy for painful varicocele, were included and followed up for 1 year after the surgery. The quantity of preoperative and postoperative pain was assessed by means of 11-point numeric rating scale (NRS). We retrospectively analyzed the outcome of surgical ligation and predictive factors of pain resolution using patient age, height, weight, body mass index, grade and location of varicocele, duration, quantity and quality (dull, dragging, aching) of pain, and postoperative pain resolution.
RESULTS
In 104 patients (91.2%), complete or marked resolution of pain was reported at follow-up 1 year after surgery. Only 10 patients (8.8%) had recurrent or persistent pain (> or =3 points in NRS scores). On multivariate analysis, low quantity (< or =6 points in NRS scores) and dull or dragging natured preoperative pain were independent factors associated with surgical success rates (p=0.004; odds ratio=1.62, p=0.012; odds ratio=1.76, respectively).
CONCLUSION
Microsurgical ligation is an effective treatment of painful varicocele. The quantity and quality of preoperative pain are independent predictive factors of pain resolution after surgery.

Keyword

Varicocele; ligation; pain

MeSH Terms

Adult
Follow-Up Studies
Humans
Ligation/methods
Male
Microsurgery/*methods
Pain Measurement
Pain, Postoperative/diagnosis/*prevention & control
Pelvic Pain/diagnosis/*surgery
Predictive Value of Tests
Retrospective Studies
Varicocele/*surgery
Young Adult

Figure

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  Fig. 1 Success rates by preoperative NRS scale and pain quality. The multivariate analysis of preoperative factors demonstrated that NRS scale and pain quality might predict the success rates of microsurgical ligation in painful varicocele patients. NRS, numeric rating scale.

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