Testicular Pain Following Laparoscopic Renal Surgery

Carl K. Gjertson, Chandru Sundaram

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Purpose: We have observed that a significant number of patients experience testicular pain following laparoscopic renal surgery. Since January 2006 all men scheduled for laparoscopic renal or adrenal surgery were followed prospectively to determine the incidence and characteristics of this pain. Materials and Methods: 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. Results: A total of 64 male patients (68 sides) met the criteria for evaluation. Ipsilateral testicular pain developed in 14 patients (21%). All patients describing pain underwent donor or radical nephrectomy. Of the 20 patients who underwent donor nephrectomy 11 (55%) experienced pain and of the 15 treated with radical nephrectomy 3 (20%) experienced pain. The gonadal vein was preserved in 29 patients and of those patients 1 had testicular pain (3.4%). When the gonadal vein was ligated 13 of 39 patients (33%) experienced pain (OR 14, 95% CI 1.7-115, p = 0.003). Mean pain intensity was 4 (range 1 to 8) and improved in all patients. Pain ceased without any intervention at a median of 34 days after surgery (range 7 to 110). There were no differences in operative time or blood loss between patients with or without testicular pain. Conclusions: Ipsilateral testicular pain can occur after laparoscopic renal surgery. The incidence is approximately 50% after donor nephrectomy but pain can also occur after radical nephrectomy. Preservation of the gonadal vein may be protective. We now warn all male patients scheduled for laparoscopic nephrectomy of the possibility of postoperative testicular pain.

Original languageEnglish
Pages (from-to)2037-2041
Number of pages5
JournalJournal of Urology
Volume180
Issue number5
DOIs
StatePublished - Nov 2008

Fingerprint

Laparoscopy
Kidney
Pain
Nephrectomy
Veins
Tissue Donors
Incidence
Operative Time
Postoperative Pain
Ambulatory Surgical Procedures
Physical Examination
Hospitalization
History

Keywords

  • laparoscopy
  • nephrectomy
  • postoperative complications
  • testis

ASJC Scopus subject areas

  • Urology

Cite this

Testicular Pain Following Laparoscopic Renal Surgery. / Gjertson, Carl K.; Sundaram, Chandru.

In: Journal of Urology, Vol. 180, No. 5, 11.2008, p. 2037-2041.

Research output: Contribution to journalArticle

Gjertson, Carl K. ; Sundaram, Chandru. / Testicular Pain Following Laparoscopic Renal Surgery. In: Journal of Urology. 2008 ; Vol. 180, No. 5. pp. 2037-2041.
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abstract = "Purpose: We have observed that a significant number of patients experience testicular pain following laparoscopic renal surgery. Since January 2006 all men scheduled for laparoscopic renal or adrenal surgery were followed prospectively to determine the incidence and characteristics of this pain. Materials and Methods: 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. Results: A total of 64 male patients (68 sides) met the criteria for evaluation. Ipsilateral testicular pain developed in 14 patients (21{\%}). All patients describing pain underwent donor or radical nephrectomy. Of the 20 patients who underwent donor nephrectomy 11 (55{\%}) experienced pain and of the 15 treated with radical nephrectomy 3 (20{\%}) experienced pain. The gonadal vein was preserved in 29 patients and of those patients 1 had testicular pain (3.4{\%}). When the gonadal vein was ligated 13 of 39 patients (33{\%}) experienced pain (OR 14, 95{\%} CI 1.7-115, p = 0.003). Mean pain intensity was 4 (range 1 to 8) and improved in all patients. Pain ceased without any intervention at a median of 34 days after surgery (range 7 to 110). There were no differences in operative time or blood loss between patients with or without testicular pain. Conclusions: Ipsilateral testicular pain can occur after laparoscopic renal surgery. The incidence is approximately 50{\%} after donor nephrectomy but pain can also occur after radical nephrectomy. Preservation of the gonadal vein may be protective. We now warn all male patients scheduled for laparoscopic nephrectomy of the possibility of postoperative testicular pain.",
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