Mp11-14 Outcomes After Isolated Epididymal Pain: A Retrospective Study

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Prostate & Genitalia (MP11)1 May 2024MP11-14 OUTCOMES AFTER ISOLATED EPIDIDYMAL PAIN: A RETROSPECTIVE STUDY David T. Chung, Dhiraj Bal, Suvig Dua, Harliv Dhillon, and Premal Patel David T. ChungDavid T. Chung , Dhiraj BalDhiraj Bal , Suvig DuaSuvig Dua , Harliv DhillonHarliv Dhillon , and Premal PatelPremal Patel View All Author Informationhttps://doi.org/10.1097/01.JU.0001008564.85995.11.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Chronic epididymitis imposes significant physical and psychosocial distress on affected patients. 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. Our goal is 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 cross sectional 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 204 patients with chronic orchialgia were identified, and among them, 74 patients specifically presented with chronic isolated epididymal pain. 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. 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. Regarding conservative therapies trialed 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 81.3% of patients (n=13) who underwent an epididymectomy had a positive response to the surgical intervention, defined as no pain on follow up. CONCLUSIONS: Chronic epididymal pain is a condition with limited data surrounding its management. Limited response was seen to conservative therapies. For those who underwent surgical intervention, all were pain free on follow up, except three patients who underwent and epididymectomy. Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e156 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information David T. Chung More articles by this author Dhiraj Bal More articles by this author Suvig Dua More articles by this author Harliv Dhillon More articles by this author Premal Patel More articles by this author Expand All Advertisement PDF downloadLoading ...