Laparoscopic varicocelectomy in the management of chronic scrotal pain.
OBJECTIVE
To evaluate the usefulness of laparoscopic varicocelectomy in the management of chronic scrotal pain.


METHODS
Between 2009 and 2011, 48 patients in total were treated with laparoscopic varicocelectomy for dull scrotal pain that worsened with physical activity and was attributed to varicoceles. All patients were followed up at 3 and 6 months and biannually thereafter with a physical examination, visual analog scale score, and ultrasonographic scan in selected cases.


RESULTS
The mean age was 38.2 years (range, 23-54 years). The mean follow-up period was 19.6 months (range, 6-26 months). Bilateral varicoceles were present in 7 patients (14.6%), and a unilateral varicocele was present in 41 (85.4%). The varicocele was grade 3 in 27 patients (56.3%), grade 2 in 20 (41.6%), and grade 1 in 1 (2.1%). The mean preoperative visual analog scale score was 4.8 on a scale from 0 to 10. The mean postoperative visual analog scale score at 3 months was 0.8. After the procedure, 42 patients (87.5%) had a significant improvement in the visual analog scale score (P<.001); 5 (10.4%) had symptom improvement, although it was not statistically significant; and 1 (2.1%) remained unchanged. During follow-up, we observed 5 recurrences (10.4%) whereas de novo hydrocele formation was identified in 4 individuals (8.3%).


CONCLUSIONS
Laparoscopic varicocelectomy is efficient in the treatment of symptomatic varicoceles with a low complication rate. However, careful patient selection is necessary because it appears that individuals presenting with sharp, radiating testicular pain and/or a low-grade varicocele are less likely to benefit from this procedure.
Endourology and Stone Services, Barts Health NHS Trust, London, England.
Stefanos
S
Kachrilas
Endourology and Stone Services, Barts Health NHS Trust, London, England.
Elenko
E
Popov
Endourology and Stone Services, Barts Health NHS Trust, London, England.
Andreas
A
Bourdoumis
Endourology and Stone Services, Barts Health NHS Trust, London, England.
Waseem
W
Akhter
Department of Urology, Medicare City Hospital, Dubai, United Arab Emirates.
Mohamed
M
El Howairis
Department of Urology, Sulaimani Surgical Teaching Hospital, Sulaimaniya, Iraq.
Ismaeel
I
Aghaways
Endourology and Stone Services, Barts Health NHS Trust, London, England.
Junaid
J
Masood
Endourology and Stone Services, Barts Health NHS Trust, London, England.
Noor
N
Buchholz
D000328:Adult; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017699:Pelvic Pain / Q000601:surgery*; D012008:Recurrence; D012611:Scrotum; D013521:Urologic Surgical Procedures, Male / Q000379:methods*; D014646:Varicocele / Q000601:surgery*; D055815:Young Adult
Laparoscopy; Scrotal pain; Varicocele; Visual analog scale score