Microsurgical varicocelectomy for recurrent or persistent varicoceles associated with orchalgia

Objectives. To assess the effectiveness of microsurgical varicocelectomy for the treatment of recurrent varicoceles associated with orchalgia. Methods. Twelve patients with recurrent (or persistent) painful varicocele underwent microsurgical varicocelectomy. Follow-up assessment was available for 11 patients and included a postoperative questionnaire and scrotal examination. Results. Pain disappeared completely in 6 of the 11 patients, and pain severity was reduced in 4 additional patients after microsurgical varicocelectomy, for an overall favorable response in 10 of 11 patients. Most men returned to full activities within 1 month after microsurgical varicocelectomy. Conclusions. Microsurgical varicocelectomy is an effective testicular-sparing treatment modality for recurrent painful varicocele and should be offered to patients who have failed conservative measures.