Experience of varicocele management during ipsilateral inguinal herniorrhaphy: a prospective study

This was a prospective study to evaluate the experience of varicocele management during ipsilateral herniorrhaphy in an inpatient urology setting.

A total of 65 patients with varicocele and inguinal hernia scheduled for herniorrhaphy were included for evaluation. They were categorized into 3 groups. Group 1 (n = 20) had painful varicocele and underwent simultaneous herniorrhaphy and varicocelectomy; group 2 (n = 20) had asymptomatic varicocele and received simultaneous herniorrhaphy and varicocelectomy; and group 3 (n = 25) had asymptomatic varicocele and underwent herniorrhaphy only. We used the Bassini method for herniorrhaphy and inguinal microsurgical varicocelectomy for varicocele. Varicocele was diagnosed by physical examination and further confirmed by Doppler ultrasonography.

The mean follow-up was 30.2 months (range, 6-56 months). Of the 20 subjects in group 1, complete resolution of scrotal pain was noticed in 14 (70%), and 2 (10%) had hydrocele after varicocelectomy. Of the 20 patients in group 2, 1 (5%) had hydrocele after surgery, and no hydrocele was noticed in group 3 after surgery. Mean operation time was significantly longer in group 1 (70.5 + or - 15.2 minutes) and group 2 (69.8 + or - 14.5 minutes) than in group 3 (38.2 + or - 17.2 minutes). One case in group 1 had recurrent varicocele 6 months after surgery. Of the 25 subjects in group 3, 2 (8%) developed painful varicocele during the follow-up period, and both of them had indirect inguinal hernia and lower body mass index.

Simultaneous herniorrhaphy and varicocelectomy are suggested for patients who have inguinal hernia and ipsilateral varicocele, but the average operation time is significantly longer and there is a higher rate of hydrocele than with herniorrhaphy only.