Effect of Varicocelectomy with or without Inguinal Herniorrhaphy on Scrotal Pain

Background and Objective: Varicocele is the abnormal dilation of the testicular veins, which is associated with scrotal pain. Assuming the existence of a relationship between inguinal canal floor laxity and the pain caused by varicocele, this study aimed to determine the effect of varicocelectomy with and without inguinal herniorrhaphy on scrotal pain in patients with varicocele. Materials and Methods: In this clinical trial, 110 patients with varicocele and pain were selected for surgery and randomly assigned to intervention and control groups. In the intervention group, varicocelectomy was performed with inguinal herniorrhaphy, and in the control group, varicocelectomy was performed without inguinal herniorrhaphy. After the operation, both groups were followed up and compared in terms of pain in the scrotum, erection, ejaculation, minor and major complications, as well as satisfaction with the surgery. Results: Average age of the patients in the intervention and control groups were 32.96±10.65 and 29.51±9.81 years, respectively (P=0.081). Moreover, the operation satisfaction scores in the intervention and control groups were 7.09±2.52 and 7.67±2.03 (P=0.185), respectively. In addition, the presence rates of scrotum pain on the seventh day post-operation were 72.7% and 74.5% (P=0.829), one-month post-operation were 49.1% and 50.9% (P=0.849), and three months post-operation were 30.9% and 38.2% (P=0.550) in the intervention and control groups, respectively. Conclusion: In patients with varicocele, both varicocelectomy with and without inguinal herniorrhaphy significantly reduced scrotal pain, increased erection and ejaculation, and resulted in equal satisfaction among patients, compared to before the operation. However, in three months, scrotal pain was reduced more in patients who underwent varicocelectomy with inguinal hernia than those who underwent varicocelectomy without inguinal hernia.