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Orchialgia After Living Donor Nephrectomy: An Underreported Entity. Transplant Direct 2022; 8:e1383. [PMID: 36299443 PMCID: PMC9592523 DOI: 10.1097/txd.0000000000001383] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 07/24/2022] [Indexed: 11/18/2022] Open
Abstract
Laparoscopic donor nephrectomy (LDN) offers advantages to the donor. The reported incidence of testicular pain after LDN varies in the literature ranging from 3% to 55%. Methods A survey was sent to 322 male LDN patients who donated from February 5, 2009, to February 5, 2019. The survey assessed if the donor had testicular pain or saw an additional medical professional after donation. Results Of the 322 surveyed, 147 (46%) responses were received. Of those who had a left nephrectomy, 39% had testicular pain; 23.8% of those patients had testicular swelling in addition. Of those who had pain, laterality of kidney donated did not impact if the patient had pain, pain onset, pain level, or pain duration. Of those who donated their right kidney, 35% had testicular pain, and 16.7% of those patients reported testicular swelling in addition. Twenty-seven symptomatic patients sought additional medical care for the testicular symptoms postdonation. Seven (25%) had hydroceles, 2 (7%) had testicular cysts, 1 had a urinary tract infection, and 16 (59%) had reassurance or no additional procedures provided. Conclusions Our results suggest that orchialgia is not as uncommon as previously thought and may be one of the most common minor complications experienced by male donors.
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Melchionna A, Collà Ruvolo C, Capece M, La Rocca R, Celentano G, Califano G, Creta M, Napolitano L, Morra S, Cilio S, Turco C, Caputo V, Longo N, Mirone V, Imbimbo C. Testicular pain and youtube™: are uploaded videos a reliable source to get information? Int J Impot Res 2022; 35:140-146. [PMID: 35136203 DOI: 10.1038/s41443-022-00536-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 01/27/2022] [Accepted: 01/28/2022] [Indexed: 01/22/2023]
Abstract
Several previous studies on YouTube™ on urological field have already been published. The aim of the current study was to evaluate the quality information of YouTubeTM videos on testicular pain. Using Google Trends tool, the frequency of worldwide YouTubeTM and Google Search on testicular pain was examined from 2010 to 2020. The keywords "testicular pain", "testicular ache" and "scrotal pain" were used on the YouTube platform and the first 100 YouTubeTM videos were analyzed for each one. The Patient Education Materials Assessment Tool (PEMAT) for Audiovisual (A/V) Materials, the DISCERN score and Misinformation tool were used to assess video quality. According to YouTube™ Search the mean relative frequency search for "testicular pain" ranged from 10.5 to 30.0%. According to GoogleTM Search it ranged from 73.7 to 91.0%, Of all 300 videos, 117 were eligible for the analysis. The median number of views, thumbs-up and thumbs-down was respectively: 47060 (interquartile range [IQR] = 6297.0-144188.0), 289 (IQR = 40-912) and 19 (IQR = 4-53). Of all videos, 68.4% and 31.6% were produced respectively by Medical Doctors and Other. The median PEMAT Actionability and Understandability scores were 66.7% and 66.7%, respectively. The median DISCERN score ranged from 1 to 5, with an overall median score of 3, defined from question 16. The median misinformation score ranged from 2 to 5. In conclusion, an increased interest on testicular pain was recorded on both YouTubeTM and Google search during the last decade. However, according to the quality assessment tools used, YouTube™ users cannot get trustful and exhaustive information on testicular pain. Therefore, authors with/without medical background should improve the quality of information on YouTube™ videos.
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Affiliation(s)
- Alberto Melchionna
- Department of Neurosciences, Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Napoli, Italy
| | - Claudia Collà Ruvolo
- Department of Neurosciences, Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Napoli, Italy.
| | - Marco Capece
- Department of Neurosciences, Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Napoli, Italy
| | - Roberto La Rocca
- Department of Neurosciences, Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Napoli, Italy
| | - Giuseppe Celentano
- Department of Neurosciences, Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Napoli, Italy
| | - Gianluigi Califano
- Department of Neurosciences, Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Napoli, Italy
| | - Massimiliano Creta
- Department of Neurosciences, Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Napoli, Italy
| | - Luigi Napolitano
- Department of Neurosciences, Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Napoli, Italy
| | - Simone Morra
- Department of Neurosciences, Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Napoli, Italy
| | - Simone Cilio
- Department of Neurosciences, Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Napoli, Italy
| | - Carmine Turco
- Department of Neurosciences, Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Napoli, Italy
| | - Vincenzo Caputo
- Department of Neurosciences, Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Napoli, Italy
| | - Nicola Longo
- Department of Neurosciences, Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Napoli, Italy
| | - Vincenzo Mirone
- Department of Neurosciences, Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Napoli, Italy
| | - Ciro Imbimbo
- Department of Neurosciences, Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Napoli, Italy
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Videourology Abstracts. J Endourol 2021. [DOI: 10.1089/end.2021.29116.vid] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kresch E, Efimenko I, Gonzalez D, Rizk PJ, Ramasamy R. Novel methods to enhance surgical sperm retrieval: a systematic review. Arab J Urol 2021; 19:227-237. [PMID: 34552774 PMCID: PMC8451700 DOI: 10.1080/2090598x.2021.1926752] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/04/2021] [Indexed: 01/04/2023] Open
Abstract
Objectives: To explore the use of novel technologies in sperm retrieval in men with azoospermia due to a production defect. Methods: We performed a Preferred Reporting Items for Systemic Reviews and Meta-Analysis (PRISMA)-compliant systemic literature review for manuscripts focussed on novel sperm-retrieval methods. We identified 30 studies suitable for qualitative analysis. Results and Conclusions: We identified multiple new promising technologies, each with its own distinct set of benefits and limitations, to enhance chances of sperm retrieval; these include the use of multiphoton microscopy, Raman spectroscopy, and full-field optical coherence tomography during a microdissection-testicular sperm extraction procedure. ORBEYE and ultrasonography technologies can also serve to better visualise areas of sperm production. Finally, artificial intelligence technology can play a role in the identification of sperm and, perhaps, better-quality sperm for use with assisted reproduction. Abbreviations: AI: artificial intelligence; ANN: artificial neural network; ART: assisted reproductive technology; 3D: three-dimensional; DNN: deep neural networks; FFOCT: full-field optical coherence tomography; H&E: haematoxylin and eosin; ICSI: intracytoplasmic sperm injection; IVF: in vitro fertilisation; MESA: micro-epididymal sperm aspiration; MeSH: Medical Subject Heading; MPM: multiphoton microscopy; (N)OA: (non-)obstructive azoospermia; SCO: Sertoli cell-only syndrome; SRR: sperm retrieval rates; TESA: testicular sperm aspiration; (micro-)TESE: (microdissection-) testicular sperm extraction; (CE)US: (contrast-enhanced) ultrasonography.
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Affiliation(s)
- Eliyahu Kresch
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Iakov Efimenko
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Daniel Gonzalez
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Paul J. Rizk
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ranjith Ramasamy
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
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Joshi CJ, Hassan A, Carabano M, Galiano RD. Up-to-date role of the dehydrated human amnion/chorion membrane (AMNIOFIX) for wound healing. Expert Opin Biol Ther 2020; 20:1125-1131. [PMID: 32580594 DOI: 10.1080/14712598.2020.1787979] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Chronic wounds pose a significant burden on patients, society, and the health-care setup. Higher costs, protracted clinical course, and increased risk of complications necessitate identifying novel treatment modalities that hasten healing and wound closure. AREAS COVERED This article covers newer available treatment modalities for chronic wounds, namely the dehydrated amniotic membrane products, biological skin substitutes, and similar therapies aimed at the healing of chronic non-healing wounds. It presents product description for Amniofix (dehydrated human amniotic/chorionic membrane) and its efficacy, compared to other similar products. EXPERT OPINION In our experience and review of available literature, we expect Amniofix to offer wound care specialists with a more effective, easy-to-use, and convenient treatment modality for chronic wounds. Amniofix and other dHACM (dehydrated human amniotic/chorionic membrane) therapies reported faster and complete healing with lower complication rates, when compared to other similar products. These features encourage the use of Amniofix in Diabetic foot ulcers and Venous Leg Ulcers, besides other conditions such as plantar fasciitis.
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Affiliation(s)
- Chitang J Joshi
- Division of Plastic and Reconstructive Surgery, Department of General Surgery, Northwestern University , Chicago, IL, USA
| | - Abbas Hassan
- Division of Plastic and Reconstructive Surgery, Department of General Surgery, Northwestern University , Chicago, IL, USA
| | - Miguel Carabano
- Division of Plastic and Reconstructive Surgery, Department of General Surgery, Northwestern University , Chicago, IL, USA
| | - Robert D Galiano
- Division of Plastic and Reconstructive Surgery, Department of General Surgery, Northwestern University , Chicago, IL, USA
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Reddy AG, Dick BP, Natale C, Akula KP, Yousif A, Hellstrom WJG. Application of Botulinum Neurotoxin in Male Sexual Dysfunction: Where Are We Now? Sex Med Rev 2020; 9:320-330. [PMID: 32641225 DOI: 10.1016/j.sxmr.2020.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 05/11/2020] [Accepted: 05/21/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Botulinum neurotoxin (BoNT) is a recognized therapeutic agent of modern medical care, routinely used to treat medical conditions affecting a variety of organ systems including the musculoskeletal, integumentary, and urological domains. Ongoing research is exploring BoNT's potential role as a therapeutic agent for a variety of male sexual pathologies. OBJECTIVE To review and analyze the literature regarding BoNT as a treatment option for male sexual dysfunction. METHODS A PubMed search was performed for English-language articles in peer-reviewed journals between 1970 and 2019 (with one article from 1897). Relevant articles referenced within these texts were also included. One article did not have an accompanied English full-text available. The following search terms were used: "Botox", "Botulinum toxin", "Botulinum toxin A", "Onabotulinum A", "Abobutlinum A", "BoNT", "BoNT-A", "Male sexual health", "Male sexual pathology", "Peyronie's disease", "Premature ejaculation", "Scrotal Pain", "Penile Retraction", "Scrotox", "Erectile Dysfunction", and "Botox in Urology". RESULTS There is interest in the potential role of BoNT in the treatment of male sexual pathologies. We identified studies that used BoNT to treat chronic scrotal content pain, premature ejaculation, erectile dysfunction, Peyronie's disease, penile retraction, and more. However, despite preclinical/clinical data indicating some potential efficacy and safety in these settings, a lack of robust clinical trial data has resulted in no current Food and Drug Administration-approved indications for the use of BoNT in the treatment of male sexual pathology. As a result, much of the current use of BoNT by today's providers is "off-label," and ongoing clinical trials aim to further elucidate the potential role of this therapeutic agent. CONCLUSION Current data suggest that BoNT could have a potential role as a treatment option for certain types of male sexual pathologies. However, more randomized controlled trial data regarding its long-term safety and efficacy are necessary before a widespread clinical adoption can take place. Reddy AG, Dick BP, Natale C, et al. Application of Botulinum Neurotoxin in Male Sexual Dysfunction: Where Are We Now?. J Sex Med 2021;9:320-330.
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Affiliation(s)
- Amit G Reddy
- Department of Urology, Tulane University School of Medicine, New Orleans, USA
| | - Brian P Dick
- Department of Urology, Tulane University School of Medicine, New Orleans, USA
| | - Caleb Natale
- Department of Urology, Tulane University School of Medicine, New Orleans, USA
| | - Kole P Akula
- Department of Urology, Tulane University School of Medicine, New Orleans, USA
| | - Ayad Yousif
- Department of Urology, Tulane University School of Medicine, New Orleans, USA
| | - Wayne J G Hellstrom
- Department of Urology, Tulane University School of Medicine, New Orleans, USA.
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Mohseni-Rad H, Razzaghdoust A, Mishan MA, Gholamrezaie HR, Hosseinkhani A. Terazosin or baclofen in young men with chronic orchialgia: A cohort study of 499 patients. Urologia 2019; 87:35-40. [PMID: 31476980 DOI: 10.1177/0391560319873531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE We aimed to investigate the comparative efficacy of terazosin and baclofen in young men with chronic orchialgia using National Institutes of Health Chronic Prostatitis Symptom Index measurement. PATIENTS AND METHODS Of 499 young men with chronic orchialgia, 255 received a daily 2 mg terazosin at bedtime and 244 received 10 mg baclofen during a period of 3 months. A daily 10-min hot-tub hip-bath rest was administered for all patients. Moreover, all patients with grade 3 and 18 patients with grade 2 varicocele underwent varicocelectomy. The National Institutes of Health Chronic Prostatitis Symptom Index score was assessed at baseline and 3 months later. RESULTS Both terazosin and baclofen groups experienced a significant reduction in mean National Institutes of Health Chronic Prostatitis Symptom Index score (24.78 and 24.81 at baseline to 19.68 and 19.60 after the treatment for terazosin and baclofen groups, respectively). However, there was no significant difference between the groups with regard to post-treatment National Institutes of Health Chronic Prostatitis Symptom Index score after adjustment for the pre-treatment score (p = 0.987). A total of 85 patients (33.4%) in terazosin group and 74 patients (30.3%) in baclofen group underwent varicocelectomy. Addition of the varicocelectomy to the treatment as a multimodal approach had no further improvement in the National Institutes of Health Chronic Prostatitis Symptom Index score. CONCLUSION Although a significant reduction was observed in mean National Institutes of Health Chronic Prostatitis Symptom Index score for both terazosin and baclofen groups, there was no significant difference between the treatments. Moreover, addition of varicocelectomy to terazosin or baclofen could not significantly decrease National Institutes of Health Chronic Prostatitis Symptom Index score; thus, varicocelectomy may not be appropriate for men who have some success with medical management. Further randomized studies are warranted.
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Affiliation(s)
- Hamed Mohseni-Rad
- Department of Urology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Abolfazl Razzaghdoust
- Urology and Nephrology Research Center, Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Amir Mishan
- Ocular Tissue Engineering Research Center, Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Gholamrezaie
- Department of Urology, Faculty of Medicine, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - Ali Hosseinkhani
- Department of Urology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
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Chaudhari R, Sharma S, Khant S, Raval K. Microsurgical Denervation of Spermatic Cord for Chronic Idiopathic Orchialgia: Long-Term Results from an Institutional Experience. World J Mens Health 2018; 37:78-84. [PMID: 30209898 PMCID: PMC6305859 DOI: 10.5534/wjmh.180035] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 07/15/2018] [Accepted: 07/20/2018] [Indexed: 12/14/2022] Open
Abstract
Purpose Chronic testicular pain remains an important challenge for urologists. At present there are many treatment modalities available for chronic orchialgia. Some patients remain in pain despite a conservative treatment. Microsurgical denervation of spermatic cord appears to be successful in relieving pain in patients who fail conservative management. We assessed the long-term efficacy, complications and patient perceptions of microsurgical denervation of the spermatic cord in the treatment of chronic orchialgia. Materials and Methods A prospective study was conducted from January 2007 to January 2016 which included men with testicular pain of >3 months duration, failure of conservative management, persistent of pain for >3 months after treating the underlying cause. Total 48 patients with 62 testicular units (14 bilateral) showed the response to spermatic cord block and underwent microsurgical denervation of spermatic cord. Results Out of 62 testicular units (14 bilateral) which were operated, complete 2 years follow-up data were available for 38 testicular units. Out of these 38 units, 31 units (81.57%) had complete pain relief, 4 units (10.52%) had partial pain, and 3 units (7.89%) were non-responders. Complications were superficial wound infection in 3 units (4.83%), hydrocele in 2 units (3.22%), subcutaneous seroma in 2 units (3.22%), and an incisional hematoma in 1unit (1.61%) out of 62 operated testicular units. Conclusions Idiopathic chronic orchialgia remains a difficult condition to manage. If surgery is considered, microsurgical denervation of spermatic cord should be considered as a first surgical approach to get rid of pain and sparing the testicle.
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Affiliation(s)
| | | | - Shahil Khant
- Department of Urology, Ruby Hall Clinic, Pune, India
| | - Krutik Raval
- Department of Urology, Ruby Hall Clinic, Pune, India
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Cho CL. Invited Commentary: Outcomes of microsurgical subinguinal varicocelectomy to treat painful recurrent varicocele. Andrologia 2018; 50:e13132. [DOI: 10.1111/and.13132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 07/23/2018] [Indexed: 12/27/2022] Open
Affiliation(s)
- Chak-Lam Cho
- Department of Surgery; Union Hospital; Hong Kong
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Calixte N, Tojuola B, Kartal I, Gudeloglu A, Hirsch M, Etafy M, Mendelson R, Djokic B, Sherba S, Shah K, Brahmbhatt J, Parekattil S. Targeted Robotic Assisted Microsurgical Denervation of the Spermatic Cord for the Treatment of Chronic Orchialgia or Groin Pain: A Single Center, Large Series Review. J Urol 2017; 199:1015-1022. [PMID: 29079446 DOI: 10.1016/j.juro.2017.10.030] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2017] [Indexed: 11/17/2022]
Abstract
PURPOSE Microsurgical denervation of the spermatic cord is a treatment option for chronic orchialgia refractory to conservative treatment. A recent study showed specific nerve fibers as the possible cause of chronic orchialgia. Our goal was to present the outcomes of ligation of these nerves using a technique of targeted robotic assisted microsurgical denervation of the spermatic cord. MATERIALS AND METHODS We retrospectively reviewed the records of 772 patients who underwent targeted robotic assisted microsurgical denervation of the spermatic cord from October 2007 to July 2016. Selection criteria were chronic testicular pain more than 3 months in duration, failed conservative treatments, negative neurological and urological workup, and temporary resolution of pain with a local anesthetic spermatic cord block. Targeted robotic assisted microsurgical denervation of the spermatic cord was performed. Pain was assessed preoperatively and postoperatively using a subjective visual analog scale and objectively with the standardized and validated PIQ-6 (Pain Impact Questionnaire-6) score. RESULTS Followup data were available on 860 cases. During a median followup of 24 months (range 1 to 70) 718 cases (83%) showed a significant reduction in pain and 142 (17%) had no change in pain by subjective visual analog scale scoring. Of cases with a significant reduction in pain 426 (49%) had complete resolution and 292 (34%) had a 50% or greater reduction. Objective PIQ-6 analysis showed a significant reduction in pain in 67% of patients 6 months postoperatively, in 68% at 1 year, in 77% at 2 years, in 86% at 3 years and in 83% at 4 years. CONCLUSIONS Targeted robotic assisted microsurgical denervation of the spermatic cord is an effective, minimally invasive approach with potential long-term durability in patients with refractory chronic orchialgia.
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Affiliation(s)
- Nahomy Calixte
- PUR Clinic and South Lake Hospital, Clermont, Florida; Keiser University Graduate School (RM, BD), Fort Lauderdale, Florida
| | - Bayo Tojuola
- PUR Clinic and South Lake Hospital, Clermont, Florida; Keiser University Graduate School (RM, BD), Fort Lauderdale, Florida
| | - Ibrahim Kartal
- PUR Clinic and South Lake Hospital, Clermont, Florida; Keiser University Graduate School (RM, BD), Fort Lauderdale, Florida
| | - Ahmet Gudeloglu
- PUR Clinic and South Lake Hospital, Clermont, Florida; Keiser University Graduate School (RM, BD), Fort Lauderdale, Florida
| | - Matthew Hirsch
- PUR Clinic and South Lake Hospital, Clermont, Florida; Keiser University Graduate School (RM, BD), Fort Lauderdale, Florida
| | - Mohamed Etafy
- PUR Clinic and South Lake Hospital, Clermont, Florida; Keiser University Graduate School (RM, BD), Fort Lauderdale, Florida
| | - Richard Mendelson
- PUR Clinic and South Lake Hospital, Clermont, Florida; Keiser University Graduate School (RM, BD), Fort Lauderdale, Florida
| | - Borivoje Djokic
- PUR Clinic and South Lake Hospital, Clermont, Florida; Keiser University Graduate School (RM, BD), Fort Lauderdale, Florida
| | - Sarah Sherba
- PUR Clinic and South Lake Hospital, Clermont, Florida; Keiser University Graduate School (RM, BD), Fort Lauderdale, Florida
| | - Kunal Shah
- PUR Clinic and South Lake Hospital, Clermont, Florida; Keiser University Graduate School (RM, BD), Fort Lauderdale, Florida
| | - Jamin Brahmbhatt
- PUR Clinic and South Lake Hospital, Clermont, Florida; Keiser University Graduate School (RM, BD), Fort Lauderdale, Florida
| | - Sijo Parekattil
- PUR Clinic and South Lake Hospital, Clermont, Florida; Keiser University Graduate School (RM, BD), Fort Lauderdale, Florida.
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Abstract
The management of patients suffering with chronic testicular and groin pain is very challenging. With increased awareness of men's health, more patients and clinicians are open to talk about this complex problem that affects over 100,000 men/year. The pathogenesis of chronic orchialgia is still not clear, but there are several postulated theories. Treatment options include conservative medical therapy with NSAIDs, antidepressants, anticonvulsants, and narcotics. Surgical options such as targeted microsurgical denervation and microcryoablation can provide permanent durable pain relief. The goal of this article is to review and discuss the management of patients with chronic orchialgia using currently available literature.
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Lowe G. Extirpative surgery for chronic orchialgia: is there a role? Transl Androl Urol 2017; 6:S2-S5. [PMID: 28725610 PMCID: PMC5503920 DOI: 10.21037/tau.2017.03.37] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 02/20/2017] [Indexed: 11/06/2022] Open
Abstract
Chronic orchialgia is a difficult and frustrating condition for both the patient and clinician. Determining appropriate course of therapy should require extensive conservative measures and consideration of alternative surgical options prior to concluding an orchiectomy is warranted. This manuscript aims to provide the clinician with the information currently available to determine if the anticipated success rate is warranted to consider extirpative surgery for idiopathic chronic orchialgia.
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Affiliation(s)
- Gregory Lowe
- Department of Urology, OhioHealth Physician Group, OhioHealth Hospitals, Columbus, OH 43214, USA
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Calixte N, Brahmbhatt J, Parekattil S. Genital pain: algorithm for management. Transl Androl Urol 2017; 6:252-257. [PMID: 28540232 PMCID: PMC5422702 DOI: 10.21037/tau.2017.03.03] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 01/13/2017] [Indexed: 11/12/2022] Open
Abstract
Chronic testicular pain although becoming very common in our patient population poses a challenge to the physician, the patient and his family. The pathogenesis of chronic orchialgia (CO) is not well understood. The objective of this paper is to review the current literature on chronic testicular pain and its management and to propose an algorithm for its treatment. Abstracts, original papers and review articles were reviewed during a literature search using words such as testicular pain, CO, and microsurgical anatomy of spermatic cord. Chronic scrotal content pain (CSP) is a difficult condition to treat and could be idiopathic or secondary. Conservative therapy is the first line of treatment attempted to allow the patient to return to his routine activities. When conservative treatment fails, patients can now turn toward surgical options such as microsurgical denervation of the spermatic cord (MDSC) which has a success rate published in the 60-85% range and/or minimally invasive therapies such as microcryoablation of the spermatic cord, Botox or Amniofix injection. There is an increase in referrals for CO. The true pathogenesis is still unclear and the road to complete recovery is unsure for certain patients. This paper proposes an algorithm for the management of patients suffering with CO.
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Affiliation(s)
- Nahomy Calixte
- South Lake Hospital, 1900 Don Wickham Drive, Clermont, FL 34711, USA
| | - Jamin Brahmbhatt
- South Lake Hospital, 1900 Don Wickham Drive, Clermont, FL 34711, USA
| | - Sijo Parekattil
- South Lake Hospital, 1900 Don Wickham Drive, Clermont, FL 34711, USA
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