Factors influencing the postoperative resolution of varicocele-associated scrotal pain.
- Author:
Yun-Long LIU
1
;
Xian-En GU
2
;
Xiao-Yi ZHANG
3
;
De-Zhong LIU
3
;
Lian ZOU
1
Author Information
1. Graduate Training Base, General Hospital of the Rocket Force / The Affiliated Hospital of Jinzhou Medical University, Beijing 100088, China.
2. Department of Urology, Beijing Chuiyangliu Hospital of Tsinghua University, Beijing 100020, China.
3. Department of Urology, General Hospital of the Rocket Force, Beijing 100088, China.
- Publication Type:Journal Article
- Keywords:
meta-analysis;
scrotal pain;
varicocelectomy;
varicocele
- MeSH:
Adult;
Genital Diseases, Male;
prevention & control;
Humans;
Laparoscopy;
Ligation;
Male;
Microsurgery;
Pain, Postoperative;
prevention & control;
Pain, Procedural;
prevention & control;
Recurrence;
Scrotum;
Testis;
Treatment Outcome;
Varicocele;
surgery;
Vascular Surgical Procedures;
Veins
- From:
National Journal of Andrology
2017;23(6):550-560
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the factors influencing the postoperative resolution of varicocele-associated scrotal pain.
METHODS:Using the keywords "varicocele", "testicular pain", "scrotal pain", "painful varicocele", "ligation", and "varicocelectomy", we searched the PubMed, Embase, Cochrane Collaboration's Database, CNKI, Wanfang, and VIP Database up to October 2016 for the studies relating to surgical treatment of varicocele-associated scrotal pain. We assessed the quality of the cohort studies included using the Newcastle-Ottawa Scale and that of the randomized controlled trials included with the Cochrane Collaboration's tool. We conducted a meta-analysis using the RevMan software.
RESULTS:Finally 14 studies were included in this meta-analysis, of which, 2 involved the history of disease, 8 involved the nature of pain, 2 involved the intensity of pain, 9 involved the grade of varicocele, 3 involved the side of varicocele, 9 involved surgical approaches, 3 involved surgical techniques, and 4 involved postoperative recurrence. The pain resolution rate was significantly higher after subinguinal ligation than after high or inguinal ligation (RR = 0.82, 95% CI: 0.76－0.89, P <0.01; RR = 0.92, 95% CI: 0.86－0.99, P = 0.02), and so was it after microsurgery than after laparoscopic varicocelectomy (RR = 0.77, 95% CI: 0.60－0.99, P = 0.04).
CONCLUSIONS:Subinguinal varicocelectomy and microsurgery are more effective options than laparoscopic and high or trans-inguinal ligation of the spermatic vein for resolution of varicocele-associated scrotal pain, while the history of disease, the nature and intensity of pain, the grade and side of varicocele, or postoperative recurrence cannot be regarded as the influencing factors.
