Predictors of success in surgical ligation of painful varicocele

Introduction: Surgical ligation is used in the treatment of painful varicocele. We conducted this retrospective study to establish the effectiveness of varicocele ligation for the treatment of pain and to examine the factors that might predict outcomes. Patients and Methods: Eighty-three patients underwent varicocele ligation for pain during the study period. Review of medical records and postal questionnaires were used to document patient age, grade and location of varicocele, duration and quality of pain, surgical approach, complications and the resolution of pain. Results: Follow-up was available for 68 (82%) patients. In 76.5% patients there was marked or complete resolution of pain and 14 had partial resolution. Only 9% patients had persistent pain and 1.5% patient reported worsening pain. The quality of pain, dull ache or dragging, was the only factor that correlated with the resolution of pain following surgery. Conclusions: Surgical ligation is an effective treatment for the painful varicocele. The quality of pain at presentation may predict outcomes in selected patients.