Bibliographic record
Abstract
Introduction: Chronic testicular pain is a common referral for urologists.Recognized causes for chronic orchialgia are many and include infection, trauma, and iatrogenic following vasectomy; however, up to 50% may be idiopathic in nature.Some patients remain in pain despite conservative treatment.Epididymectomy, vasovasostomy, and microdenervation of the spermatic cord (MDSC) are surgical options for chronic orchialgia reported in the literature.We aimed to assess the safety and efficacy of outpatient surgical intervention for patients with chronic orchialgia.Methods: We evaluated our prospective database of patients who underwent outpatient epididymectomy, vasovasostomy, or MDSC under local anesthesia and/or IV deep sedation between August 2022 and January 2023.Surgical management was offered to patients who had orchialgia >3 months and had failed conservative management.To evaluate short-term safety and efficacy, we scheduled followup at 4-6 weeks postoperative.Patients who still had residual pain were scheduled for additional followup at 2-3 months.Demographic, perioperative, and followup data were collected.Results: Twenty-nine patients underwent surgery for chronic orchialgia, 12 of whom are pending followup.Demographics, perioperative, and followup data can be seen in Table 1.Among epididymectomy patients, all had localized epididymal tenderness, 78% had prior scrotal surgery, and 75% were pain-free at 4-6 weeks postoperative.Only one patient had a postoperative complication consisting of a hematoma that did not require intervention.All epididymectomy surgeries except for one were performed using local anesthetic.Patients who underwent vasovasostomy all had post-vasectomy pain with localized epididymal tenderness; 50% were pain-free at 4-6 weeks postoperative.Of the MDSC patients, 80% had generalized scrotal pain, 40% had prior epididymectomies for orchialgia, and 60% were pain-free at 4-6 weeks postoperative.All vasovasostomy and MDSC surgeries were done under IV deep sedation plus local anesthetic.Conclusions: Our ongoing study demonstrates that outpatient epididymectomy, vasovasostomy, and MDSC are safe and effective surgical options for patients with chronic orchialgia.Continuation of this study will aim to capture more patients undergoing these procedures and track their followup.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.002 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.593 | 0.277 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; the direct Gemma label and the distilled Codex classifier agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".