Prevention of Orchialgia After Left-Sided Laparoscopic Donor Nephrectomy—A Prospective Study

Sureka, Sanjoy Kumar; Srivastava, Aneesh; Agarwal, Shikhar; Srivastava, Alok; An, Sachin; Singh, Sanjeet Kumar; Mittal, Varun; Patidar, Nitesh; Kapoor, Rakesh; Ansari, M. Sib

doi:10.1089/end.2014.0645

Cited by 11 publications

(12 citation statements)

References 15 publications

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“…The appearance of chronic pain in the groin, even severe, and diminished skin sensitivity are well‐documented unwanted effects of surgical and interventional procedures to the kidney and after hernia repair. Pain may rarely be acute and referred to the testis 18 . This pathologic condition is due to iatrogenic injury to the genitofemoral nerve and the pelvic plexus 18,19 …”

Section: Other Causes Of Acute Pain Referred To the Scrotummentioning

confidence: 99%

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Nonscrotal Causes of Acute Scrotum

Campo

Valentino²,

Sidhu

et al. 2020

J of Ultrasound Medicine

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Acute scrotum is characterized by intense acute scrotal pain, which may be associated with other symptoms and signs such as abdominal pain, inflammation, and fever. Many pathologic conditions can present in this way, most which involve the scrotal contents. Nonscrotal conditions, however, can rarely present clinically only as acute scrotum: among them, renal colic, aneurysm rupture or other causes of retroperitoneal hemorrhage, primary abdominal or pelvic tumors and metastases, pancreatitis, pelvic inflammation, and muscle injuries. The pathophysiologic characteristics of the clinical presentation, clues for diagnosis, and imaging features of a series of nonscrotal lesions presenting clinically with acute scrotal pain are herein reported and illustrated. In patients presenting with acute scrotal symptoms and normal scrotal ultrasound findings, nonscrotal causes of acute scrotal pain should be considered in the differential diagnosis. Therefore, an ultrasound investigation of the abdomen, groin, and thighs is indicated.

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Section: Other Causes Of Acute Pain Referred To the Scrotummentioning

confidence: 99%

“…Pain may rarely be acute and referred to the testis 18 . This pathologic condition is due to iatrogenic injury to the genitofemoral nerve and the pelvic plexus 18,19 …”

Section: Other Causes Of Acute Pain Referred To the Scrotummentioning

confidence: 99%

Nonscrotal Causes of Acute Scrotum

Campo

Valentino²,

Sidhu

et al. 2020

J of Ultrasound Medicine

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“…There are three possible explanations of post-LDN testicular pain: vascular congestion resulting from gonadal vein ligation, testicular ischemia due to testicular artery disruption, and neural damage of the spermatic plexus. It has been proposed that the gonadal vein ligation above the bifurcation of iliac vessels could reduce this complication incidence [ 8 – 10 ]. Few studies compared the incidence of testicular pain in donors undergoing ODN versus LDN.…”

Section: Introductionmentioning

confidence: 99%

Post-Laparoendoscopic Single-Site Donor Nephrectomy Ipsilateral Testicular Pain, Does Operative Technique Matter? A Single Center Experience and Review of Literature

Hennawy

Faifi

Atta

et al. 2022

Minimally Invasive Surgery

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Aim. To assess incidence and characteristics of post-laparoendoscopic single-site donor nephrectomy (LESS DN) testicular pain. Materials and Methods. A prospective comparative study of all male donors post-left LESS DN (group A) vs. postopen nephrectomies (group B) was performed at our center. Patients’ demographics, perioperative data, and postoperative consultation reports were reviewed. Testicular pain, swelling, numbness, urinary symptoms, and sexual dysfunction were evaluated. Patients with a history of scrotal pathology or surgical procedure were excluded. Pain and tenderness were scored on a standard 10-point scale. Results. From September 2017 to December 2020, 85 and 35 male patients of groups A and B met the evaluation criteria. Ipsilateral testicular pain developed in 11 patients (15.3%) and 2 patients (9.5%) in groups A and B, respectively. In most instances, the pain was mild to moderate in severity, started after 6 ± 2.1 and 4 ± 1.1 days postoperatively in groups A and B, respectively. Six patients in group A were evaluated with transscrotal ultrasonography that showed no abnormalities. All patients in both groups responded well to medical treatment. Conclusions. Post-LESS DN ipsilateral testicular pain is usually mild and self-limited. Preoperative patient education and discussion of the possibility of development of testicular pain and its management should be an integral component of laparoscopic donor nephrectomy informed consent.

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“…When we talk about CSP, this is usually defined as chronic pain that has been persistent for more than three months and other causes such as an infection, testicular mass, torsion, hydrocele, abscess and referred pain due to some type of upper tract issue have been ruled out. 2,4 Patients may present as idiopathic pain, 1 post-vasectomy pain, 5,6 postinguinal hernia pain, 7,9 post-traumatic pain, 3 post-abdominal surgery pain, 10,12 postabdominal radiation pain, 13 post-cardiac catheterization (inguinal approach) pain, 14 etc. Initially, conservative treatment options be initiated such as medical therapy and/or neuromodulation techniques (pelvic floor therapy, acupuncture, etc.).…”

Section: Introductionmentioning

confidence: 99%

<p>Management of Chronic Orchialgia: Challenges and Solutions – The Current Standard of Care</p>

Parekattıl¹,

Ergun²,

Güdeloğlu³

2020

RRU

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Introduction Chronic scrotal content pain (CSP) or chronic orchialgia can be debilitating for patients and difficult to treat. There is a paucity of structured treatment algorithms to approach this difficult condition. Methods A review of the literature was performed. Conservative treatment options are presented and then targeted surgical interventions that the urologist may perform are then presented in a structured algorithm format. Many of these patients may obtain a significant reduction in pain with some of these treatments. Results This review presents the pathophysiology, a new assessment tool, and various treatment options available for CSP patients, such as targeted spermatic cord blocks, targeted and standard microsurgical denervation of the spermatic cord (77–100% success rates), ultrasound-guided peri-spermatic cord and ilioinguinal cryoablation (59–75% success rates), scrotox (botox) (56–72% success rates), targeted ilioinguinal and iliohypogastric peripheral nerve stimulation (72% success rate), radical orchiectomy (20–75% success rate), targeted robotic-assisted intra-abdominal denervation (71% success rate) and vasectomy reversal (69–100% success rates). Conclusion A structured and evidence-based approach to help urologists manage patients with chronic orchialgia or scrotal content pain is presented.

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Prevention of Orchialgia After Left-Sided Laparoscopic Donor Nephrectomy—A Prospective Study

Abstract: The level of ligation of the GV and ureter has significant impact on the incidence of orchialgia. Ipsilateral testicular pain in patients with left-sided LDN is preventable, if the ureter and GV are ligated or clipped above the level of iliac vessels bifurcation.

Cited by 11 publications

References 15 publications

Nonscrotal Causes of Acute Scrotum

Nonscrotal Causes of Acute Scrotum

Post-Laparoendoscopic Single-Site Donor Nephrectomy Ipsilateral Testicular Pain, Does Operative Technique Matter? A Single Center Experience and Review of Literature

<p>Management of Chronic Orchialgia: Challenges and Solutions – The Current Standard of Care</p>

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