Table 3. Summary of different predictors for pain improvement in most recent studies.
| Study | Sample size | Predictive factors | Pain outcome post-varicocelectomy | Conclusion |
|---|---|---|---|---|
| Lv et al. 2016 (16) | 345 | Laparoscopic varicocelectomy (LV); microscopic inguinal varicocelectomy (MIV); microscopic retroperitoneal varicocelectomy (MRV); microscopic subinguinal varicocelectomy (MSV) |
Scrotal pain was relieved in almost all patients in the MSV group at a significantly higher rate than LV, MIV, and MRV groups (P<0.05) | MSV is the most beneficial of the 4 spermatic vein ligation procedures and may be offered as the first-line treatment for VC in infertile men |
| Abrol et al. 2014 (6) | Critical appraisal of 13 studies from March 2000 to May 2013 | Grade of varicocele; quality of pain; duration of pain; intensity of pain; recurrence of varicocele; type of varicocele ligation; other (semen analysis results, hormonal profile data, maximum vein diameter, peak retrograde flow on Doppler, distance from renal hilum to center of scrotum, scrotal temperature, and BMI) | No association between any factor and pain resolution after surgery. Only the quality and duration of pain seemed to be both independent predictors of success in resolving pain post-surgery | Surgical success does not always translate into resolution of pain. Pain might persist even when no varicoceles are detected postoperatively |
| Park et al. 2011 (12) | 77 | Varicocele grade; duration of pain; type of varicocele ligation; follicle stimulating hormone (FSH); luteinizing hormone (LH); testosterone; other (scrotal ultrasonography and semen analysis results, age, and BMI) | No association between any predictor and pain resolution after surgery. Only the duration of pain seemed to be a factor that is considerably associated with pain resolution | The duration of pain (≥3 months) was an independent prognostic factor for the complete response of pain and the resolution of pain |
| Abd Ellatif et al. 2012 (11) | 152 | Varicocele grade; quality of pain; type of varicocele ligation; recurrence of varicocele; duration of pain | No association between any predictor and pain resolution after surgery. Only the duration of pain seemed to be a factor that is considerably associated with pain resolution | Varicocelectomy is a successful option for treatment of painful varicocele in selected patients. The duration of pain may predict outcomes in these patients |
| Söylemez et al. 2012 (17) | 40 | Laparoscopic varicocelectomy; microscopic subinguinal varicocelectomy | Reduced postoperative pain and earlier return to normal activity was higher in laparoscopic varicocelectomy. However, the number of recurrences and hydroceles, as a complication of laparoscopic varicocelectomy, was higher than microscopic subinguinal varicocelectomy | Laparoscopic varicocelectomy is a safe, effective, and minimally invasive procedure to treat pain |