Department of Urology, Pusan National University School of Medicine, Medical Research Institute, Pusan National University, Busan 602-739, Korea.
Asian J Androl. 2011 Sep;13(5):754-8. doi: 10.1038/aja.2010.87. Epub 2010 Nov 22.
Varicocelectomy is a management option for patients with painful varicocele. In this study, we assessed the effectiveness of varicocelectomy for painful varicocele and examined the factors that might be predictive of outcome. All patients who underwent a varicocelectomy for pain between February 2007 and July 2009 were included. A review of patient medical records was conducted; patient age, body mass index (BMI), grade, location of the varicocele, testicular volume, duration and quality of the pain (dull, dragging, throbbing or sharp) and surgical technique (inguinal versus subinguinal) were documented. All parameters were compared with the resolution of pain (complete, partial or failure). We followed up on 53 of 104 patients (51.0%). Complete postoperative resolution of pain was reported by 28 patients (52.8%), whereas 22 (41.5%) reported partial resolution. Only three patients (5.7%) reported failure. No relationship was observed between postoperative pain resolution and age, BMI, grade of varicocele, location of varicocele, ipsilateral testicular hypotrophy, quality of pain or surgical technique. The duration of pain before surgery was the only factor that correlated with postoperative pain resolution (univariate, P=0.004; multivariate, P=0.002). Our results indicate that varicocelectomy is an effective treatment for painful varicocele in properly selected patients, and that duration of pain before surgery may be predictive of outcome.
精索静脉结扎术是治疗精索静脉曲张性疼痛的一种方法。本研究旨在评估精索静脉结扎术治疗精索静脉曲张性疼痛的疗效，并探讨可能预测手术结果的因素。所有 2007 年 2 月至 2009 年 7 月期间因精索静脉曲张性疼痛而接受精索静脉结扎术的患者均纳入本研究。回顾性分析患者的病历资料，记录患者的年龄、体重指数（BMI）、精索静脉曲张分级、精索静脉曲张部位、睾丸体积、疼痛持续时间和性质（隐痛、牵拉痛、搏动性痛或锐痛）以及手术方式（腹股沟切口或经腹膜后切口）。所有参数均与疼痛缓解情况（完全缓解、部分缓解或失败）进行比较。最终随访了 104 例患者中的 53 例（51.0%）。28 例（52.8%）患者术后疼痛完全缓解，22 例（41.5%）患者疼痛部分缓解，仅 3 例（5.7%）患者疼痛缓解失败。术后疼痛缓解与患者年龄、BMI、精索静脉曲张分级、精索静脉曲张部位、对侧睾丸萎缩、疼痛性质或手术方式均无相关性。术前疼痛持续时间是唯一与术后疼痛缓解相关的因素（单因素分析，P=0.004；多因素分析，P=0.002）。我们的研究结果表明，对于选择恰当的患者，精索静脉结扎术是治疗精索静脉曲张性疼痛的有效方法，而术前疼痛持续时间可能是预测手术效果的因素。
