Retroperitoneal high ligation versus subinguinal varicocelectomy: Effectiveness of two different varicocelectomy techniques on the treatment of painful varicocele

Andrologia. 2019 Aug;51(7):e13293. doi: 10.1111/and.13293. Epub 2019 Apr 17.

Abstract

In the present study, we compared the retroperitoneal high ligation with subinguinal varicocelectomy on the treatment of painful varicocele. A total of 90 patients who underwent retroperitoneal high ligation (n = 45) and subinguinal varicocelectomy (n = 45) for painful varicocele were included in this prospective study. Varicocele in all patients was diagnosed with by physical examination and coloured Doppler ultrasonography. All the patients underwent a conservative treatment for pain for 4 weeks. Patient ages, varicocele grades, preoperative pain scores, postoperative pain scores at 6 months, duration of surgeries, complications and recurrences were recorded. Complete success rate for chronic scrotal pain was found to be 80% in retroperitoneal varicocelectomy group and 71% in subinguinal varicocelectomy group. Partial success rate was 11% for retroperitoneal varicocelectomy group and 18% for subinguinal ligation group. There was no significant difference between two groups in terms of pain and complications. However, the operation time was significantly lower in the Palomo group. Although microsurgical subinguinal varicocelectomy is the current approach for the treatment of varicocele, retroperitoneal high ligation can achieve the same pain resolution with shorter operative duration compared to loupe-assisted subinguinal varicocelectomy.

Keywords: Palomo; pain; scrotal; subinguinal; varicocele.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Chronic Pain / diagnosis
  • Chronic Pain / etiology
  • Chronic Pain / therapy*
  • Humans
  • Ligation / adverse effects
  • Ligation / methods
  • Male
  • Microsurgery / adverse effects*
  • Microsurgery / methods
  • Operative Time
  • Pain Measurement
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Prospective Studies
  • Recurrence
  • Retroperitoneal Space
  • Retrospective Studies
  • Scrotum / blood supply
  • Scrotum / diagnostic imaging
  • Scrotum / surgery
  • Treatment Outcome
  • Ultrasonography, Doppler
  • Urologic Surgical Procedures, Male / adverse effects
  • Urologic Surgical Procedures, Male / methods*
  • Varicocele / complications
  • Varicocele / diagnostic imaging
  • Varicocele / surgery*
  • Vascular Surgical Procedures / adverse effects*
  • Vascular Surgical Procedures / methods
  • Young Adult