Duration of preoperative scrotal pain may predict the success of microsurgical varicocelectomy.

PURPOSE Varicocelectomy is used in the treatment of scrotal pain. We report our results with microsurgical subinguinal varicocele ligation to treat pain. MATERIALS AND METHODS A total of 284 men underwent subinguinal microsurgical varicocele ligation for scrotal pain. All patients were asked to return for a follow-up evaluation 3 months after surgery, which included a physical examination, as well as questions on pain severity, number of days required before their return to work and development of any postoperative complications. RESULTS Median patient age at the time of varicocele ligation was 23.7 years (range 16-38 years). The average duration of pain before presentation was 11.2 months (range 1 month to 40 months). In 85.6% patients there was complete resolution of pain and 6.3% had partial resolution. Pain persisted postoperatively in 19 cases (8.1%). There were statistically non-significant differences in the characteristics of the pain and grade of varicocele between postoperative groups. A significant difference was observed in postoperative success between patients who had long period and those who had short period of pain. CONCLUSIONS Sub-inguinal microsurgical varicocele ligation is an effective treatment for painful varicocele. The duration of pain preoperatively may predict outcomes in selected patients.