The Effectiveness of Varicocelectomy in Patients with Painful Varicocele

Ryu, Dong Soo; Chong, Chang Ho; Oh, Tae Hee

Abstract

PURPOSE: The benefits of varicocelectomy in improving semen quality and pregnancy rate has been clearly demonstrated. However, the reports on the effects of varicocelectomy in patient with painful varicocele are few. We evaluate the efficacy of varicocelectomy with modified Palomo method and microsurgical subinguinal method in these patients. MATERIAL AND METHODS: 109 consecutive patients who underwent varicocelectomy with follow up period more than 3 months were enrolled in the study. We analyzed the degree of varicocele, effects of surgical treatment and results according to surgical technique and grade of varicocele. The result was classified into completely resolved, partially resolved and unchanged based on the relief of pain. The outcome of varicocelectomy was assessed retrospectively either by review of patient's medical records or telephone and letter interview.
RESULTS
Of 109 patients, 43 patients (39.4%) underwent varicocelectomy with modified Palomo method and microsurgical subinguinal method for pain. Of those 43 patients, 34 (79.0%) reported complete resolution of pain postoperatively, 4 patients (9.4%) showed partial resolution, 5 patients (11.6%) showed no change. Of the 5 patients with no change, 3 patients had no abnormal finding by postoperative ultrasonography and remaining 2 patients had recurrence of varicocele. There were no statistically significant differences in resolution rate between two surgical methods and among each grade (Chi-square test; p=0.749, 0.690).
CONCLUSIONS
Surgical treatment of varicocele is an effective treatment for relief of pain in properly selected patients.