Outpatient varicocelectomy performed under local anesthesia.
OBJECTIVE
To report a series of varicocelectomy performed under pure local anesthesia.


METHODS
From July 1988 to June 2003, a total of 575 patients, aged between 15 and 73 years, underwent high ligation of the internal spermatic vein for treatment of a varicocele testis under a regional block in which a precise injection of 0.8 % lidocaine solution was delivered to involved tissues after exact anatomical references were made. A 100-mm visual analog scale (VAS) was used to assess whether the pain level was acceptable.


RESULTS
The surgeries were bilateral in 52 cases, and unilateral in 523 cases. All were successfully performed on an outpatient basis except in the case of two patients, who were hospitalized because their surgeries required general anesthesia. Overall, 98.6 % (567/575) of men could go back to work by the end of the first post-operative week and only 8 (1.4 %) men reported feeling physical discomfort on the eighth day. The VAS scores varied from 11 mm to 41 mm with an average of (18.5+/-11.3) mm that was regarded as tolerable.


CONCLUSIONS
This study has shown varicocelectomy under local anesthesia to be possible, simple, effective, reliable and reproducible, and a safe method with minimal complications. It offers the advantages of more privacy, lower morbidity, with no notable adverse effects resulting from anesthesia, and a more rapid return to regular physical activity with minor complications.
Hsu
Geng-Long
GL
Microsurgical Potency Reconstruction and Research Center, Taiwan Adventist Hospital, 424, Pa Te Road, Sec. 2, Taipei 105, Taiwan, China. glhsu@tahsda.org.tw
Ling
Pei-Ying
PY
Hsieh
Cheng-Hsing
CH
Wang
Chii-Jye
CJ
Chen
Cheng-Wen
CW
Wen
Hsien-Sheng
HS
Huang
Hsiu-Mei
HM
Einhorn
E Ferdinand
EF
Tseng
Guo-Fang
GF
D000082:Acetaminophen / Q000008:administration & dosage; D000293:Adolescent; D000328:Adult; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage; D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D010149:Postoperative Pain / Q000188:drug therapy; D011183:Postoperative Complications; D014646:Varicocele / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods*
D018712:Analgesics, Non-Narcotic; D000779:Anesthetics, Local; D000082:Acetaminophen; D008012:Lidocaine