Effect of microsurgical subinguinal varicocele ligation to treat pain

Objectives. The traditional treatment for a painful varicocele consists of conservative measures followed by varicocelectomy. We report our results wi th microsurgical subinguinal varicocele ligation to treat pain. Methods. From 1996 to 1999, a total of 119 men underwent subinguinal micros urgical varicocele ligation for painful varicocele. The diagnosis of varico cele was based on the findings of both physical examination and color Doppl er ultrasound. Patients described pain with testicular discomfort as scrota l heaviness or a dull ache. While waiting for the operation (range 3 to 5 w eeks), all the patients underwent a preoperative trial of conservative mana gement for pain. Results. Of 119 men, 82 (69%) were available for follow-up 3 months postope ratively. Of those 82 patients, 72 (88%) reported complete resolution of pa in, 4 patients (5%) partial resolution, 5 patients (6%) no change, and 1 pa tient (1%) epididymal discomfort that resolved with conservative measures. Of the 9 patients with partial or no change, 2 patients had reflux recurren ce as seen on color Doppler ultrasound. Conclusions. Subinguinal microsurgical varicocele ligation is an effective treatment for painful varicocele when performed in selected patients. (C) 2 000, Elsevier Science Inc.