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Query: UNIPROT:P56851 (epididymal)
 11,273 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The incidence of chronic testicular pain following vasectomy has not been previously assessed. We have carried out a survey by postal questionnaire and telephone interview of 172 patients 4 years after vasectomy to assess the incidence of chronic testicular pain. Significant early post-operative complications occurred in 6 patients (3.5%): 2 infection, 3 haematoma and 1 orchitis. Chronic testicular discomfort was present in 56 patients (33%), considered by 26 (15%) to be troublesome but not by the other 30 (17%). Testicular discomfort related to sexual intercourse occurred in 9 cases (5%). Of the 9 patients who had sought further medical help only 2 had had further surgery (1 an epididymectomy and 1 excision of a hydrocele). Only 3 patients regretted having had the vasectomy because of chronic pain. On ultrasound examination, epididymal cysts were a common finding on both asymptomatic and symptomatic patients following vasectomy. Prior to vasectomy, all patients should be counselled with regard to the risk of chronic testicular pain.
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PMID:Chronic testicular pain following vasectomy. 142 2

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.
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PMID:Chronic epididymitis: is epididymectomy a valid surgical treatment? 1838 Jul 87

Chronic orchialgia is a vexing condition defined as chronic or intermittent scrotal pain lasting at least three months that significantly interferes with daily activities. There are currently no guidelines regarding the diagnosis and management of this condition despite it being the cause of 2.5-4.8% of urologic clinic visits. Men often present with chronic orchialgia in their mid to late 30s, although the condition can present at any age. A broad differential diagnosis of chronic orchialgia includes epididymitis, testicular torsion, tumors, obstruction, varicocele, epididymal cysts, hydrocele, iatrogenic injury following vasectomy or hernia repair, and referred pain from a variety of sources including mid-ureteral stone, indirect inguinal hernia, aortic or common iliac artery aneurysms, lower back disorders, interstitial cystitis, and nerve entrapment due to perineural fibrosis; approximately 25-50% of chronic orchialgia is idiopathic in nature. In such cases, it is reasonable to consider psychological and psychosocial factors that may be contributing to chronic pain. Invasive testing is not recommended in the work-up of chronic orchialgia.
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PMID:Chronic orchialgia: epidemiology, diagnosis and evaluation. 2872 16