Microsurgical Ligation for Painful Varicocele: Effectiveness and Predictors of Pain Resolution
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Purpose: We evaluated the effectiveness of microsurgical ligation for painful varicocele and predictive factors of pain resolution. Materials and Methods: Between January 2006 and March 2009, a total of 114 patients (mean age, 30.2±8.9 years), who underwent microsurgical inguinal varicocelectomy for painful varicocele, were included and followed up for 1 year after the surgery. The quantity of preoperative and postoperative pain was assessed by means of 11-point numeric rating scale (NRS). We retrospectively analyzed the outcome of surgical ligation and predictive factors of pain resolution using patient age, height, weight, body mass index,grade and location of varicocele, duration, quantity and quality (dull, dragging,aching) of pain, and postoperative pain resolution. Results: In 104 patients (91.2%), complete or marked resolution of pain was reported at follow-up 1 year after surgery. Only 10 patients (8.8%) had recurrent or persistent pain (≥3 points in NRS scores). On multivariate analysis, low quantity (≤6 points in NRS scores) and dull or dragging natured preoperative pain were independent factors associated with surgical success rates (p=0.004; odds ratio=1.62, p=0.012; odds ratio=1.76, respectively). Conclusion: Microsurgical ligation is an effective treatment of painful varicocele. The quantity and quality of preoperative pain are independent predictive factors of pain resolution after surgery.
Abstract
Purpose: We evaluated the effectiveness of microsurgical ligation for painful varicocele and predictive factors of pain resolution. Materials and Methods: Between January 2006 and March 2009, a total of 114 patients (mean age, 30.2±8.9 years), who underwent microsurgical inguinal varicocelectomy for painful varicocele, were included and followed up for 1 year after the surgery. The quantity of preoperative and postoperative pain was assessed by means of 11-point numeric rating scale (NRS). We retrospectively analyzed the outcome of surgical ligation and predictive factors of pain resolution using patient age, height, weight, body mass index,grade and location of varicocele, duration, quantity and quality (dull, dragging,aching) of pain, and postoperative pain resolution. Results: In 104 patients (91.2%), complete or marked resolution of pain was reported at follow-up 1 year after surgery. Only 10 patients (8.8%) had recurrent or persistent pain (≥3 points in NRS scores). On multivariate analysis, low quantity (≤6 points in NRS scores) and dull or dragging natured preoperative pain were independent factors associated with surgical success rates (p=0.004; odds ratio=1.62, p=0.012; odds ratio=1.76, respectively). Conclusion: Microsurgical ligation is an effective treatment of painful varicocele. The quantity and quality of preoperative pain are independent predictive factors of pain resolution after surgery.
참고문헌 (17)
- Karademir K, "Evaluation of the role of varicocelectomy including external spermatic vein ligation in patients with scrotal pain", Int J Urol, 12, pp.484~488 (2005)
- Chawla A, "Microsurgical varicocelectomy for recurrent or persistent varicoceles associated with orchalgia", Urology, 66, pp.1072~1074 (2005)
- Yaman O, "Effect of microsurgical subinguinal varicocele ligation to treat pain", Urology, 55, pp.107~108 (2000)
- Gontero P, "Inguinal versus subinguinal varicocele vein ligation using magnifying loupe under local anesthesia: which technique is preferable in clinical practice?", Urology, 66, pp.1075~1079 (2005)
- Riccabona M, "Optimizing the operative treatment of boys with varicocele: sequential comparison of 4 techniques", J Urol, 169, pp.666~668 (2003)
- Amelar RD, "Early and late complications of inguinal varicocelectomy", J Urol, 170, pp.366~369 (2003)
- 신주현, "정계정맥류의 수술 방법: 후복막 접근법, 후복막 접근 고환동맥 보존법, 서혜부 접근 미세수술의 비교", Korean Journal of Urology, 47(10), pp.1086~1092 (2006), 대한비뇨기과학회
- Lipshultz LI, "Campbell-Walsh Urology. 9th ed", pp.654~717 (2007), WB Saunders
- Ishikawa T, "Effect of age and grade on surgery for patients with varicocele", Urology, 65, pp.768~772 (2005)
- Ribé N, "Clinical follow-up after subinguinal varicocele ligation to treat pain", Arch Ital Urol Androl, 74, pp.51~53 (2002)
- Peterson AC, "Outcomes of varicocele ligation done for pain", J Urol, 159, pp.1565~1567 (1998)
- Al-Buheissi SZ, "Predictors of success in surgical ligation of painful varicocele", Urol Int, 79, pp.33~36 (2007)
- Cayan S, "Comparison of results and complications of high ligation surgery and microsurgical high inguinal varicocelectomy in the treatment of varicocele", Urology, 55, pp.750~754 (2000)
- 이정우, "미세술기를 이용한 저위서혜부 정계정맥류제거술:소아와 성인에서의 비교", Korean Journal of Urology, 49(11), pp.1029~1034 (2008), 대한비뇨기과학회
- Yaman O, "Results of microsurgical subinguinal varicocelectomy in children and adolescents", Urology, 68, pp.410~412 (2006)
- Levine LA, "Microsurgical denervation of the spermatic cord: a surgical alternative in the treatment of chronic orchialgia", J Urol, 155, pp.1005~1007 (1996)
- Breivik H, "Assessment of pain", Br J Anaesth, 101, pp.17~24 (2008)