Chronic epididymitis: is epididymectomy a valid surgical treatment?
| Autor: | James T. Hill, Junaid Masood, J.G. Calleary |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Urology Endocrinology Diabetes and Metabolism Physical examination Scrotum Epididymectomy medicine Humans Retrospective Studies Epididymitis medicine.diagnostic_test business.industry Chronic pain Retrospective cohort study Middle Aged medicine.disease Surgery medicine.anatomical_structure Reproductive Medicine Chronic Disease Etiology business Scrotal Pain |
| Zdroj: | International Journal of Andrology. 32:468-472 |
| ISSN: | 1365-2605 0105-6263 |
| DOI: | 10.1111/j.1365-2605.2008.00880.x |
| Popis: | Chronic scrotal pain (>or=3 months) is multi-factorial in nature and difficult to treat. Epididymectomy for chronic epididymal pain is rarely performed because of perceived poor outcome. We retrospectively audited our results, when published 'cure' following testicular denervation is 97%. The records of 32 males (35 consecutive epididymectomies) were retrospectively analysed. Thirteen had previous scrotal surgery. Eight (group one) had palpable painful epididymal abnormalities on clinical examination, nine (group two) had ultrasonic abnormalities but no palpable abnormality and 15 (group three) had neither. Pain response was recorded as: cured, improved, recurred or no change/worse. The mean time to operation was 23.83 months (2-121) and follow-up was 15.57 months (1-84). There were no significant aetiological differences between groups. In group one, 87.5% were cured with the remainder improved. Sixty-seven per cent of group two had a satisfactory outcome. Of group three, 20% were cured and a further 33% improved. Prior scrotal surgery, duration of symptoms and age were not predictive of outcome (Kruskal-Wallis) in terms of pain relief. Epididymectomy for structural abnormalities had excellent results. Those with chronic pain, normal examination and ultrasound had at best, a 55% chance of improvement. This group must be counselled about the low risk of success. The identification of the optimal surgical management of this difficult problem requires a multi-national registry study. |
| Databáze: | OpenAIRE |
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