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Who will benefit from surgical repair for painful varicocele: a meta-analysis

  • Urology – Original Paper
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Abstract

Purpose

To determine the efficacy of different surgical approaches and techniques for resolving varicocele-related pain and factors that predict surgical outcomes.

Methods

The PubMed and Embase databases were searched with the terms “varicocele”, “varicocelectomy” and “pain”. Manual searches by reviewing the references of included studies were performed. Studies were included when they focused on the influence of varicocele grade, pain quality, different surgical approaches or techniques on pain resolution. A meta-analysis was conducted with RevMan5.3 software.

Results

Twelve studies were identified in the analysis. No significant correlation was found between varicocele grade and pain resolution (P > 0.05). The resolution rate for dull pain was significantly higher than sharp pain [RR = 1.11, 95 % CI (1.02, 1.22), P = 0.02], and there were no other significant differences between the qualities of pain and pain resolution. The pain resolution rate was significantly higher after subinguinal varicocelectomy than after high or inguinal varicocelectomy [RR = 0.83, 95 % CI (0.76, 0.90), P < 0.00001 and RR = 0.92, 95 % CI (0.86, 0.99), P = 0.02]. The pain resolution rate was significantly higher after microsurgery than after laparoscopic varicocelectomy [RR = 0.77, 95 % CI (0.60, 0.99), P = 0.04].

Conclusion

Subinguinal varicocelectomy and microsurgical varicocelectomy are efficacious for resolving varicocele-related pain compared to other approaches and techniques. Pain quality is a factor that predicts surgical outcomes while varicocele grade is not. Additional controlled studies are warranted to clearly define this clinical problem.

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Author contributions

D.Y.H., C.H.D. and X.Z.S. conceived of the study, participated in its design and coordinated and drafted the manuscript. D.Y.H., Q.Y.Y. and B.Y. participated in the literature search and evaluation for bias. X.C., H.Z. and Y.B.O. extracted the data. D.Y.H. and K.X. performed the statistical analyses. G.H.L., C.H.D. and X.Z.S. gave critical advice and participated in manuscript revising. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Department of Urology, The First Affiliated Hospital, Sun Yat-Sen University, No. 58, Zhongshan 2nd Road, Guangzhou, 510080, China

    Da-Yu Han, Qi-Yun Yang, Xu Chen, Heng Zhang, Kai Xia, Chun-Hua Deng & Xiang-Zhou Sun

  2. Department of Urology, Guangzhou First People’s Hospital, Guangzhou Medical University, Guangzhou, 510180, China

    Bin Ouyang

  3. Department of Urology, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510655, China

    Bing Yao

  4. Reproductive Medicine Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510655, China

    Gui-Hua Liu

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  1. Da-Yu Han
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Corresponding author

Correspondence to Xiang-Zhou Sun.

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All the authors declare that there is no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Han, DY., Yang, QY., Chen, X. et al. Who will benefit from surgical repair for painful varicocele: a meta-analysis. Int Urol Nephrol 48, 1071–1078 (2016). https://doi.org/10.1007/s11255-016-1246-7

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  • DOI: https://doi.org/10.1007/s11255-016-1246-7

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