(116) OUTPATIENT SURGICAL MANAGEMENT FOR CHRONIC SCROTAL PAIN
Notice bibliographique
Résumé
Abstract Introduction Chronic scrotal pain is a prevalent and difficult condition to manage. It presents a diagnostic and therapeutic challenge due to its diverse etiology and variable clinical manifestations. While some cases can be attributed to identifiable causes such as infection, trauma, or surgical interventions, a considerable portion remains idiopathic. Many patients continue to experience persistent pain despite conservative treatment. Surgical interventions like epididymectomy, vasovasostomy, and microdenervation of the spermatic cord (MDSC) have been documented in the literature as potential options for chronic scrotal pain. Objective In our study, we aimed to evaluate the safety and effectiveness of outpatient surgical interventions for patients dealing with chronic scrotal pain. Methods We conducted a review of our prospective patient database of consecutive patients who underwent epididymectomy, vasovasostomy, or microdenervation of the spermatic cord (MDSC) for chronic scrotal pain at our outpatient surgical center. All patients followed a standardized patient flow. Patients were initially seen by a family physician at our center and trailed on conservative management. Patients who failed conservative management were then assessed by a urologist and offered surgical management depending on the location and character of the pain. Patients exhibiting localized epididymal pain, bilateral post-vasectomy discomfort, or generalized scrotal pain with a positive response to cord block were offered epididymectomy, vasovasostomy, or MDSC respectively. Safety and efficacy evaluations were performed through postoperative follow-up appointments at 1-2 months and 6-12 months. Results From August 2022 to May 2024, 94 patients underwent surgery for chronic scrotal pain. Demographics, perioperative, and follow-up data can be seen in Table 1. Among epididymectomy patients (n = 52), 42 patients had complete resolution of pain and 6 patients reported >50% improvement in pain. Of 3 men with recurrent pain, 2 were pain free after orchiectomy and MDSC respectively. 2 patients had small non-operative hematomas. Among vasovasostomy patients (n = 10), 6 patients had completely resolution of pain and 3 patients reported >50% improvement in pain. 1 patient had acute scrotal pain immediately post-op that was self-limited. Among MDSC patients (n = 32), 21 patients had complete resolution of pain and 7 patients reported >50% improvement in pain. Greater than 80% of patients were satisfied with the outcome of their procedure and expressed they would undergo the same procedure again. Conclusions Effective management of chronic scrotal pain remains a multifaceted problem involving conservative and surgical options. Consistent with the literature, our study found that outpatient epididymectomy, vasovasostomy, and MDSC are safe and effective surgical options for patients with chronic scrotal pain in carefully selected patients. Our study highlights the importance of standardized patient flow in selecting the appropriate patient for each surgical option. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,014 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».