A prospective study of hd laparoscopic varicocele ligation for chronic scrotal pain

Introduction: The prevalence of varicocele is approximately 15% in the general population, and about 2 -10 % of them have chronic scrotal pain. Microsurgical or Laparoscopic testicular vein ligations are preferred surgical options for the patient refractory to conservative therapy. Previous studies have proved the superiority of microscopic surgeries in painful varicocele treatment but the newer HD endo-vision system has improved laparoscopic vision quality signicantly and testicular veins are identied more precisely than ever before. So there is a need to relook the results of laparoscopic varicocele ligation. We have done a prospective observational study to assess patients' perceived changes in scrotal pain scores preand-post HD laparoscopic varicocele ligation. Materials and Methods: This prospective observational study was conducted at a tertiary care referral center. All patients with scrotal pain were evaluated for varicocele between September 2017 and December 2018. Varicocele patients with normal semen count with chronic scrotal pain not responding to conservative therapy were included in the study. The Laparoscopic varicocele ligation surgeries were done by HD endo-vision system under general or spinal anesthesia. Preoperative and post-operative universal pain scores were compared by Student's pair t-test. Result: A total of 34 patients (mean age, 26.2±3.9 years) underwent Laparoscopic varicocele ligation for scrotal pain symptoms. Thirty-two patients (94.11%) reported complete or marked resolution of pain at 3 months follow-up. There was no early or late postoperative complication reported in any study patient. There was a marked improvement in the mean universal pain score, from 5.6 preoperatively to 1.1 postoperatively (p=0.00011). Conclusion: HD Laparoscopic varicocele ligation has a very high success rate with minimal post-operative complications in painful varicocele management.