Testicular Pain Found Common Following Laparoscopic Surgery

A new study has found that a significant number of renal surgery patients experience testicular pain following a laparoscopic procedure, but preservation of the gonadal vein could reduce this incidence.

Researchers at the University of Connecticut Health Center (UCHC, Farmington, USA) followed prospectively all men scheduled for laparoscopic renal or adrenal surgery at the UCHC from January 2006 onwards to determine the incidence and characteristics of this pain. All patients had a history and physical examination before surgery, during postoperative hospitalization, and 4 weeks after surgery; pain and tenderness were scored on a standard 10-point scale. Preoperative and postoperative data were collected prospectively. A total of 64 patients (68 sides) met the criteria for evaluation.

The results showed all patients describing pain underwent either donor or radical nephrectomy. Of the 20 patients who underwent donor nephrectomy, 11 (55%) experienced pain, and of the 15 treated with radical nephrectomy, only 3 (20%) experienced pain. The gonadal vein was preserved in 29 patients and of those patients, one had testicular pain (3.4%); when the gonadal vein was ligated, however, 13 of 39 patients (33%) experienced pain. Mean pain intensity was four, which subsequently improved in all patients; pain ceased without any intervention at a median of 34 days after surgery. There were no differences in operative time or blood loss between patients with or without testicular pain. The study was published in the November 2008 issue of the Journal of Urology.

"We now warn all male patients scheduled for laparoscopic nephrectomy of the possibility of postoperative testicular pain,” said study authors Carl Gjertson, M.D., and Chandru Sundaram, M.D., of the division of urology. "Preservation of the gonadal vein may be protective.”

A significant number of patients experience testicular pain following laparoscopic renal surgery; the incidence rate is approximately 50% after donor nephrectomy, but pain can also occur after radical nephrectomy.

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