PDF(Pubmed)
Abstract：
UNASSIGNED: Varicocelectomy is the prevailing management of scrotal pain secondary to varicocele. However, the literature is controversial on this topic. Some data showed that pain may persist after the surgery even if the varicocele is not detected postoperatively.
UNASSIGNED: The objectives of the study were to identify the effect of varicocelectomy in patients with chronic scrotal pain, to report the association between the clinical grade and postoperative pain resolution, and to identify the need for a secondary procedure after varicocelectomy to control the pain.
UNASSIGNED: This was a retrospective study of 47 patients who underwent varicocelectomy between March 2016 and December 2018.
UNASSIGNED: Postoperatively, the pain totally resolved after surgery in 64.3% of patients with scrotal pain; it improved in 21.4%, 11.9% have persistent pain, and the pain got worse in only 2.4%. Our study showed 100% complete resolution or improvement with Grade I, 85.7% in Grade II, and 81.3% in Grade III. In addition, all patients who underwent bilateral varicocelectomy had pain that either completely resolved or improved postoperatively. On the other hand, all patients who had persistent pain or pain worsening postoperatively had unilateral varicocelectomy. An additional intervention for postoperative pain control was needed in only 14% of patients, 7% of them underwent embolization, 4.7% had a cord block, and 2.3% were sent to a pain clinic.
UNASSIGNED: Varicocelectomy offers good outcomes in most patients with varicocele-related scrotal pain. The most significant predictor for success was low grade and bilaterality. However, there is a subset of patients whose symptoms will not improve postoperatively. Careful preoperative counseling and expectation management are crucial when discussing surgical options for those patients.
UNASSIGNED: The objectives of the study were to identify the effect of varicocelectomy in patients with chronic scrotal pain, to report the association between the clinical grade and postoperative pain resolution, and to identify the need for a secondary procedure after varicocelectomy to control the pain.
UNASSIGNED: This was a retrospective study of 47 patients who underwent varicocelectomy between March 2016 and December 2018.
UNASSIGNED: Postoperatively, the pain totally resolved after surgery in 64.3% of patients with scrotal pain; it improved in 21.4%, 11.9% have persistent pain, and the pain got worse in only 2.4%. Our study showed 100% complete resolution or improvement with Grade I, 85.7% in Grade II, and 81.3% in Grade III. In addition, all patients who underwent bilateral varicocelectomy had pain that either completely resolved or improved postoperatively. On the other hand, all patients who had persistent pain or pain worsening postoperatively had unilateral varicocelectomy. An additional intervention for postoperative pain control was needed in only 14% of patients, 7% of them underwent embolization, 4.7% had a cord block, and 2.3% were sent to a pain clinic.
UNASSIGNED: Varicocelectomy offers good outcomes in most patients with varicocele-related scrotal pain. The most significant predictor for success was low grade and bilaterality. However, there is a subset of patients whose symptoms will not improve postoperatively. Careful preoperative counseling and expectation management are crucial when discussing surgical options for those patients.
摘要：
■精索静脉曲张切除术是继发于精索静脉曲张的阴囊疼痛的主要治疗方法。然而,文献在这个话题上是有争议的。一些数据表明，即使术后未检测到精索静脉曲张，疼痛也可能在手术后持续存在。
■本研究的目的是确定精索静脉曲张切除术对慢性阴囊疼痛患者的影响，报告临床等级和术后疼痛缓解之间的关联，并确定是否需要在精索静脉曲张切除术后进行二次手术以控制疼痛。
这是一项对2016年3月至2018年12月期间接受精索静脉曲张切除术的47例患者的回顾性研究。
■术后，64.3%的阴囊疼痛患者术后疼痛完全缓解；21.4%的患者术后疼痛好转，11.9%有持续性疼痛，只有2.4%的人疼痛加重。我们的研究显示100％完全解决或改善与一级，二级85.7%,三级为81.3%。此外,所有接受双侧精索静脉曲张切除术的患者术后疼痛完全缓解或好转.另一方面,所有术后持续疼痛或疼痛恶化的患者均接受单侧精索静脉曲张切除术.只有14%的患者需要额外的术后疼痛控制干预，其中7％进行了栓塞，4.7%有脐带阻滞，2.3%被送往疼痛诊所。
■精索静脉曲张相关阴囊痛的大多数患者行精索静脉曲张切除术可获得良好的治疗效果。成功的最重要预测因素是低等级和双边性。然而,有一部分患者术后症状没有改善.在讨论这些患者的手术选择时，仔细的术前咨询和期望管理至关重要。
■本研究的目的是确定精索静脉曲张切除术对慢性阴囊疼痛患者的影响，报告临床等级和术后疼痛缓解之间的关联，并确定是否需要在精索静脉曲张切除术后进行二次手术以控制疼痛。
这是一项对2016年3月至2018年12月期间接受精索静脉曲张切除术的47例患者的回顾性研究。
■术后，64.3%的阴囊疼痛患者术后疼痛完全缓解；21.4%的患者术后疼痛好转，11.9%有持续性疼痛，只有2.4%的人疼痛加重。我们的研究显示100％完全解决或改善与一级，二级85.7%,三级为81.3%。此外,所有接受双侧精索静脉曲张切除术的患者术后疼痛完全缓解或好转.另一方面,所有术后持续疼痛或疼痛恶化的患者均接受单侧精索静脉曲张切除术.只有14%的患者需要额外的术后疼痛控制干预，其中7％进行了栓塞，4.7%有脐带阻滞，2.3%被送往疼痛诊所。
■精索静脉曲张相关阴囊痛的大多数患者行精索静脉曲张切除术可获得良好的治疗效果。成功的最重要预测因素是低等级和双边性。然而,有一部分患者术后症状没有改善.在讨论这些患者的手术选择时，仔细的术前咨询和期望管理至关重要。
