title: The effectiveness of varicocele embolisation for the treatment of varicocele related orchalgia.
abstract: OBJECTIVE
  Orchalgia is a common problem with varicoceles however the association between varicocele embolisation for the treatment of varicocele related pain has not been widely investigated. We aim to investigate the effectiveness of varicocele embolisation for the treatment of orchalgia secondary to varicoceles; and to see if pre-embolisation pain scores can be used to predict treatment outcomes.
  
  
  METHODS
  A prospectively collected database of patients undergoing varicocele embolisation for pain was analysed over a 10-year period. Pain scores were assessed with a 10-point visual analogue score. Analgesia requirements and satisfaction scores were assessed with questionnaires.
  
  
  RESULTS
  Total of 96 cases. Median age was 34 years old. Median pain scores reduced significantly following embolisation (p < 0.001). 74% had reduced pain (30% of these had resolution of pain), 24% had no change in symptoms and 1% had worsening pain. Those with moderate or severe pain had a reduction of pain in 81 and 79% of cases respectively, however 64% of cases with mild pain did not experience any benefit. We also noted a reduction in analgesia requirements and a median satisfaction score of 8/10.
  
  
  CONCLUSIONS
  Primary varicocele embolisation can successfully reduce varicocele related orchalgia. It works best in those with moderate or severe pain. The majority of patients with mild pain may not experience any benefit so should be counseled appropriately. The classification of patients into those with mild, moderate or severe symptoms prior to embolisation should be done, so robust consenting can be performed.
authors.affiliation: School of cancer sciences, University of Birmingham, Birmingham, UK.
authors.forename: David W
authors.initials: DW
authors.lastname: Muthuveloe
authors.affiliation: School of cancer sciences, University of Birmingham, Birmingham, UK.
authors.forename: Vinnie
authors.initials: V
authors.lastname: During
authors.affiliation: Cambridge Health at Work, Cambridge Biomedical Campus, Hills Road, Cambridge, UK.
authors.forename: Daniel
authors.initials: D
authors.lastname: Ashdown
authors.affiliation: The Royal Wolverhampton Hospital NHS Trust, Wolverhampton, UK.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Rukin
authors.affiliation: Interventional Radiology Department, University Hospitals Birmingham, Birmingham, UK.
authors.forename: Rob G
authors.initials: RG
authors.lastname: Jones
authors.affiliation: School of cancer sciences, University of Birmingham, Birmingham, UK.
authors.forename: Prashant
authors.initials: P
authors.lastname: Patel
keywords: Varicocele; Varicocele embolization; Varicocele related orchalgia