title: Varicocelectomy to treat pain, and predictors of success: a prospective study.
abstract: OBJECTIVE
  We attempted to examine the success rate of varicocele ligation when performed for the treatment of pain and to evaluate all the predictor factors that may affect the resolution of pain.
  
  
  METHODS
  From January 2008 to January 2011, a total 152 patients presented with painful varicocele to our out-patient clinic. While waiting for surgery, 7 patients (4.6%) resolved their pain with conservative management and 145 patients underwent varicocelectomy due to failure. The first follow-up visit was after 1 week to check the wounds and 130 patients attended the second visit after 3 months. Follow-up evaluation included physical examination, questioning of pain severity (compared with preoperative pain severity), development of any postoperative complications, and color Doppler to study recurrence reflux.
  
  
  RESULTS
  During the study period, 145/397 (36.5%) patients underwent varicocelectomy for pain. Of the 145 men operated on for pain 130 (89.6%) were available for follow-up. A subinguinal approach was used in 93 patients (71.5%) and high ligation in 37(28.5%). Of the 130 patients contacted after surgery, 109 (83.8%) reported complete resolution of pain, 7 (5.4%) had partial resolution of pain and 14 did not show benefit from surgery. There was no association between varicocele grade, quality of pain, type of varicocele ligation, or recurrence and pain resolution after surgery, only the duration of pain seems to be a factor that is considerably associated with pain resolution.
  
  
  CONCLUSIONS
  Varicocelectomy is a successful option for treatment of painful varicocele in selected patients. The duration of pain may predict outcomes in these patients.
authors.affiliation: General Surgical Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Mohamed E
authors.initials: ME
authors.lastname: Abd Ellatif
authors.affiliation: General Surgical Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Waleed
authors.initials: W
authors.lastname: Asker
authors.affiliation: General Surgical Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Abbas
authors.affiliation: General Surgical Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Ahamed
authors.initials: A
authors.lastname: Negm
authors.affiliation: General Surgical Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Al-Katary
authors.affiliation: General Surgical Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Haitham
authors.initials: H
authors.lastname: El-Kaffas
authors.affiliation: General Surgical Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Moatamed
keywords: Outcome; Pain; Varicocele; Varicocelectomy