Preoperative Predictors of Varicocelectomy Success in the Treatment of Testicular Pain

PURPOSE: We performed the present study to evaluate the prognostic factors for the surgical outcome of varicocelectomy in the treatment of a painful varicocele. MATERIALS AND METHODS: A total of 77 patients undergoing varicocelectomy were enrolled. All the patients were examined for body mass index (BMI), varicocele grade, testosterone, follicle stimulating hormone (FSH), luteinizing hormone (LH), semen analysis, maximal vein diameter, and discrepancy of testicular volume. At a follow-up visit 3~6 months after the surgery, the patient response was graded as a complete response, partial response, or no response. The resolution of pain was defined as a complete or partial response. We used logistic regression analyses to determine the preoperative factors for predicting a complete response and the resolution of pain. RESULTS: Ten subjects were lost to follow-up. The remaining 67 patients were included in this study. The pain was completely resolved in 47.8% of patients, partial resolution was observed in 25.4% of patients, and failure was reported in 26.9% of patients. Among the parameters, only a longer duration of pain (≥3 months) was an independent factor related to the complete response of pain (odds ratio, 7.371; p=0.010) and the resolution of pain (odds ratio, 7.209; p=0.042). The parameters of semen analysis results, testosterone, LH, FSH, BMI, grade, ultrasonography results, and the type of surgical approach did not significantly predict the resolution of pain. CONCLUSIONS: The duration of pain (≥3 months) was an independent prognostic factor for the complete response of pain and the resolution of pain.