Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul-Sep;15(3):311-314.
doi: 10.4103/UA.UA_64_20. Epub 2023 Jul 17.

Varicocelectomy for scrotal pain: Is it effective?

Abdullah Alkhayal  1   2 , Sahar Aljumaiah  1 , Abdullah Alhagbani  2 , Muhannad Alnahdi  2 , Saad Abumelha  1   2 , Khalid Alrabeeah  1   2
Affiliations

Varicocelectomy for scrotal pain: Is it effective?

Abdullah Alkhayal et al. Urol Ann. 2023 Jul-Sep.

Abstract

Introduction: Varicocelectomy is the prevailing management of scrotal pain secondary to varicocele. However, the literature is controversial on this topic. Some data showed that pain may persist after the surgery even if the varicocele is not detected postoperatively.

Objectives: The objectives of the study were to identify the effect of varicocelectomy in patients with chronic scrotal pain, to report the association between the clinical grade and postoperative pain resolution, and to identify the need for a secondary procedure after varicocelectomy to control the pain.

Materials and methods: This was a retrospective study of 47 patients who underwent varicocelectomy between March 2016 and December 2018.

Results: Postoperatively, the pain totally resolved after surgery in 64.3% of patients with scrotal pain; it improved in 21.4%, 11.9% have persistent pain, and the pain got worse in only 2.4%. Our study showed 100% complete resolution or improvement with Grade I, 85.7% in Grade II, and 81.3% in Grade III. In addition, all patients who underwent bilateral varicocelectomy had pain that either completely resolved or improved postoperatively. On the other hand, all patients who had persistent pain or pain worsening postoperatively had unilateral varicocelectomy. An additional intervention for postoperative pain control was needed in only 14% of patients, 7% of them underwent embolization, 4.7% had a cord block, and 2.3% were sent to a pain clinic.

Conclusion: Varicocelectomy offers good outcomes in most patients with varicocele-related scrotal pain. The most significant predictor for success was low grade and bilaterality. However, there is a subset of patients whose symptoms will not improve postoperatively. Careful preoperative counseling and expectation management are crucial when discussing surgical options for those patients.

Keywords: Scrotal pain; varicocele; varicocelectomy.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Chart 1
Chart 1
Patient flow chart
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Han DY, Yang QY, Chen X, Ouyang B, Yao B, Liu GH, et al. Who will benefit from surgical repair for painful varicocele:A meta-analysis. Int Urol Nephrol. 2016;48:1071–8. - PubMed
    1. Owen RC, McCormick BJ, Figler BD, Coward RM. A review of varicocele repair for pain. Transl Androl Urol. 2017;6:S20–9. - PMC - PubMed
    1. Practice Committee of the American Society for Reproductive Medicine. Society for Male Reproduction and Urology. Report on varicocele and infertility:A committee opinion. Fertil Steril. 2014;102:1556–60. - PubMed
    1. Chu DI, Zderic SA, Shukla AR, Srinivasan AK, Tasian GE, Weiss DA, et al. Does varicocelectomy improve semen analysis outcomes in adolescents without testicular asymmetry? J Pediatr Urol. 2017;13:76.e1. - PMC - PubMed
    1. Mehta A, Goldstein M. Microsurgical varicocelectomy:A review. Asian J Androl. 2013;15:56–60. - PMC - PubMed

LinkOut - more resources