Scrotal Pain after Varicocelectomy: A Narrative Review

Abstract

Varicocele is a frequently encountered urological disorder, which has a prevalence rate of 8 to 15% among healthy men. However, the incidence is higher in male patients with primary or secondary infertility, with up to 35 to 80% of varicocele cases occurring in this population. The clinical manifestations of varicocele typically include the presence of an asymptomatic mass that feels like a "bag of worms", chronic scrotal pain, and infertility. Most patients with varicocele only undergo varicocelectomy after conservative treatments have failed. Unfortunately, some patients may still experience persistent scrotal pain due to a recurrence of varicocele, the development of hydrocele, neuralgia, referred pain, ureteral lesions, or nutcracker syndrome. Therefore, clinicians should consider these conditions as potential causes of postoperative scrotal pain, and take measures to address them. Several factors can assist in predicting surgical outcomes for patients with varicocele. Clinicians should consider these factors when deciding whether to perform surgery and what type of surgical intervention to use. By doing so, they can increase the likelihood of a successful surgical outcome and minimize the risk of complications such as postoperative scrotal pain.

Keywords: chronic scrotal pain; infertility; postoperative pain; varicocelectomy.

Figure 1

The scheme of pampiniform plexus; a loose network of small veins found within the male spermatic cord. The varicocele is a condition in which the veins in the scrotum, the loose pouch of skin that contains the testicles, become enlarged. These veins are responsible for carrying blood that has been depleted of oxygen away from the testicles. When blood begins to accumulate in the veins instead of flowing out of the scrotum, a varicocele develops.