(080) Outcomes After Isolated Epididymal Pain
Bibliographic record
Abstract
Abstract Introduction Chronic epididymitis imposes significant physical and psychosocial distress on affected patients. Despite being a commonly encountered urologic condition, there remains a paucity of understanding and literature surrounding the management and natural history of isolated epididymal pain. Typically, patients who do not respond to conservative management undergo an epididymectomy. However, the literature on its efficacy is also scarce, with success rates varying widely from 10-90% in existing studies. Objective To better describe the etiology, pathogenesis and natural history of isolated epididymal pain. Furthermore, we aimed to describe the rates of success associated with epididymectomy. Methods A retrospective cohort study was conducted at the Manitoba Men’s Health Clinic, with approved by the University of Manitoba REB. All patients presenting with chronic epididymitis, defined as discomfort or pain localized to the epididymis for at least three months, were identified. Information regarding patient demographics, past medical and surgical history, duration of pain, localization of pain, findings on previous ultrasounds, STI testing results, prior conservative therapies trialed and response rates, as well as response rates to surgical therapy were collected. Results From April 2022 to 2023, a total of 274 patients with chronic orchialgia were identified, and among them, 74 patients specifically presented with chronic isolated epididymal pain. The average duration of symptoms was as follows: 21.6% (n=16) of patients experienced symptoms for 3-6 months, 9.5% (n=7) for 6-12 months, and 63.5% (n=47) for over 12 months. 13.5% (n=10) had associated ejaculatory pain, 8.1% (n=6) had lower urinary tract symptoms, and 4.1% (n=3) had erectile dysfunction. Ultrasound findings were observed in 68.9% of patients, with 31.1% having an epididymal cyst, 27.1% having a varicocele, 5.4% having a spermatocele, and 4.1% having a hydrocele. 49.4% (n=40) did not undergo any intervention prior to referral. After referral, 58.8% (n=43) of patients had undergone antibiotic treatment, 12.2% (n=9) had tried an NSAID, and one patient was referred for pelvic floor physical therapy. Among those who underwent conservative therapy, only 36.2% of patients reported a positive response. Surgical intervention was performed on 23 patients, including 16 who underwent an epididymectomy, three who underwent cord denervation, and two who underwent vasovasostomy and spermatocelectomy each. 81.3% of patients (n=13) who underwent an epididymectomy had a positive response to the surgical intervention, defined as satisfactory improvement of pain, while all patients undergoing other surgical interventions experienced a positive response. Conclusions Chronic epididymal pain is a condition with limited data surrounding its management. Prior to referral, a large proportion of patients did not undergo any conservative treatment, and of those that did, there was limited response rates. For those who underwent surgical intervention, all were pain free on follow up, except three patients who underwent and epididymectomy. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
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; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
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".