Pain relief after varicocele embolization: The patient's perspective.

INTRODUCTION

Long-term efficacy of treatment with varicocele embolization is poorly documented from the patient's perspective. This study assessed patients' perceived changes in pain scores pre- and post-testicular vein embolization. In addition, the effect of testicular vein embolization on quality of life (QoL) parameters was assessed.

METHODS

All patients treated with embolization for varicocele-related orchalgia were analysed (2009-2015). A standardized pain impact questionnaire was used to assess pain scores pre- and post-procedure. The primary outcome was to assess patients' pain relief post-varicocele embolization. The secondary outcome was patients' perceived efficacy of the embolization procedure in terms of improvement in QoL parameters.

RESULTS

Sixty patients underwent varicocele embolization due to persistent orchalgia; of which 44 responded to the questionnaire. The mean pre-procedural pain score was 5.4/10 (range of 1.5-9). Post-procedure questionnaire was performed at a median of 58 months (range 28-106 months). At 1, 6 and 12 months post-procedure, the mean pain score was 1.57, 0.55 and 0.3, respectively. 50% (n = 22) reported complete pain relief 1-month post-embolization while 89% (n = 39) of patients reported complete resolution of pain at 1 year. Among the measured QoL parameters; varicocele embolization resulted in significant improvement in return to work, housework, socializing, exercise, sexual relations, and sleeping post-embolization (P < 0.01).

CONCLUSION

Varicocele embolization results in a durable reduction in pain scores compared to their pre-operative values. Information from this study will allow clinicians to convey the potential improvements in pain parameters to patients undergoing embolization of symptomatic varicoceles.