The Use of Testosterone in the Treatment of Chronic Postvasectomy Pain Syndrome: Case Report and Review of the Literature

Pienkos, Edward J.

doi:10.7205/milmed.172.6.676

Cited by 4 publications

(3 citation statements)

References 18 publications

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“…From animal studies, there is a general consensus that the penetration of germ cells into the epididymis or the space of the vas deferens will produce autoimmune and/or inflammatory reactions, which will lead to the formation of a sperm granuloma [ 28 ]. These opalescent granulomatous nodules appear at the end of the vas deferens or epididymis and consist of a central part of degenerated sperm, which is surrounded by a layer of epithelioid macrophages and, in turn, by loose connective tissue rich in lymphocytes and plasma cells [ 29 ].…”

Section: Resultsmentioning

confidence: 99%

Review of Vasectomy Complications and Safety Concerns

Yang

Dong

et al. 2021

World J Mens Health

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Vasectomy is a simple, safe, effective, and economical method used worldwide for long-term male contraception. As a surgical operation, it has short-term and long-term complications such as hematoma formation, infection, sterilization failure, sperm granulomas, short-term postoperative pain (nodal pain, scrotal pain, and ejaculation pain), and chronic pain syndrome. Whether it increases the risk of autoimmune disease, cardiovascular disease, testicular cancer, or prostate cancer is still controversial. Changes in plasma concentrations of luteinizing hormone, follicle-stimulating hormone, and testosterone after vasectomy have also been studied, as well as the relation between vasectomy and sexual function. Sperm quality decreases very slowly after vasectomy, and vasovasostomy and intracytoplasmic sperm injection could help a couple achieve a pregnancy if they change their minds at any point. We include a follow-up strategy and suggestions for follow-up care at the end of this review.

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Section: Resultsmentioning

confidence: 99%

Review of Vasectomy Complications and Safety Concerns

Yang

Dong

et al. 2021

World J Mens Health

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“…Despite the several studies conducted after different periods from gonadectomy (a few days, 3-4 months) (9,21,(25)(26)(27) and the studies on the effects R. Ahmadi, Sh. Oryan of sex steroids on pain modulation through the different kinds of painful stimulation (8,28,29) there are still conflicting data and complexity (7,30) in this area particularly from a time-dependent aspect of issue.…”

Section: Introductionmentioning

confidence: 98%

“…In experiments with electrical stimulation to induce tail withdrawal in rats, it has been observed that castration resulted in significant reduction of pain threshold which returned to normal level on substitution with testosterone therapy (9). Recently the effects of testosterone in the treatment of chronic postvasectomy pain syndrome (10) and the protective role of testosterone in the development of temporomandibular joint pain (11) have been established.…”

Section: Introductionmentioning

confidence: 98%

sex difference and effects of gonadal hormones on thermal pain thershold in rat

Ahmadi¹

2009

Acta Endo (Buc)

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Various clinical and experimental studies indicate that gonadal hormones exert modulatory effects on nociception and analgesia.The aim of the present study was to investigate the role of gonadal hormones in the response by male and female rats to thermal nociceptive stimulation.Materials and Methods. 7 week old albino (Wistar) rats were used in our study. Animals were randomly divided into control, sham and ovariectomised or orchidectomised groups. Thermal pain threshold was measured through tail immersion test before and 10, 20 or 40 days after gonadectomy. The pain threshold was measured as the time required to elicit a flick of the tail called analgesia time. Serum testosterone, estradiol, progesterone or prolactin levels were measured simultaneously.The results showed that analgesia time was higher in female (5.11 min) than in male (4.93 min) intact animals (p<0.05) indicating sex difference in response to thermal nociception. Serum testosterone, estradiol or progesterone level as well as analgesia time were not significantly reduced 10 days after gondectomy. In male animals, analgesia time was significantly decreased (p<0.01) 20 or 40 days after orchidectomy (2.25 or 2.14 min, respectively) compared with control rats (4.93 min). Serum testosterone concentration was significantly reduced (p<0.05) 20 or 40 days after orchidectomy (0.08 or 0.09 ng/mL, respectively) compared with control serum testosterone level (2.14 ng/mL). In female rats, analgesia time was significantly decreased (p<0.001) 20 or 40 days after ovariectomy (2.87 or 2.66 min, respectively) compared with control rats (5.11 min). Serum estradiol concentration was significantly reduced (p<0.001) 20 or 40 days after ovariectomy (3.17 or 0.87 ng/mL, respectively) compared with control serum estradiol level (19.95 ng/ml). Serum progesterone level was also decreased (p<0.001) 20 or 40 days after orchidectomy (5.27 or 0.55 ng/mL, respectively) compared with control serum estradiol level (17.66 ng/mL). Serum prolactin level was not significantly enhanced during experiment indicating that there was not heat stress influencing the procedure.Conclusively, our findings clearly indicate that depletion of gonadal hormones 20 or 40 days after gonadectomy modulates the pain-induced behavioral responses related to thermal nociception.

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Spezielle Schmerzzustände in der Urologie

Klotz

Moormann

2009

Urologe

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The diagnosis of acute or chronic pain syndromes of the urogenital system can be verified and successfully treated by exact exploration of the patients medical history, the physical examination and a few image-guided or laboratory analyses Pain conditions which remain of unknown etiology even after extensive investigations are difficult to treat by the urologist alone. In cases where no causally determined morphological changes can be found or the alteration is disproportionate to the discomfort sensed by the patient, a multidisciplinary therapy strategy offers an approach to find a solution.

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The Use of Testosterone in the Treatment of Chronic Postvasectomy Pain Syndrome: Case Report and Review of the Literature

Cited by 4 publications

References 18 publications

Review of Vasectomy Complications and Safety Concerns

Review of Vasectomy Complications and Safety Concerns

sex difference and effects of gonadal hormones on thermal pain thershold in rat

Spezielle Schmerzzustände in der Urologie

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