PURPOSE: Orchialgia after laproscopic renal surgery has been rarely reported in literature, and gonadal vein ligation is considered the main etiology. Our objective was to study the incidence, intensity and to find out any specific factors that could lead to orchialgia. MATERIALS AND METHODS: All patients planned for laproscopic renal surgery between Jan 2009 and July 2011 had a history and physical examination before surgery, in postoperative period, and after discharge. Pain was scored on a standard 10-point scale approved by the NIH. Baseline, perioperative, and postoperative data were collected prospectively. RESULTS: A total of 460 laproscopic renal surgeries were performed on males out of which 440 met our criteria of evaluation. A total of 38 patients had ipsilateral orchialgia (8.52 %). The pain was more common for left-sided procedures. Mean pain intensity was 3.2. On statistical analysis, there was no difference in the operative parameters between patients of pain and those without pain except that the level of ligation of ureter and that of gonadal vein were significantly associated with orchialgia (p value <0.001 and 0.003, respectively) with the odds ratio for ligating them below the crossing of iliac vessels being 6.443 (3.098-13.397) and 4.457 (2.165-9.176), respectively. CONCLUSION: Ipsilateral orchialgia is common in patients undergoing laproscopic renal surgery specially after radical nephroureterectomy and nephrectomy specially when the ureter and gonadal vein are taken down at or below their crossing of iliac vessels. Taking down ureter above, rather than below, the iliac vessels whenever possible may be preventive as is the preservation of gonadal vein.
PURPOSE: Orchialgia after laproscopic renal surgery has been rarely reported in literature, and gonadal vein ligation is considered the main etiology. Our objective was to study the incidence, intensity and to find out any specific factors that could lead to orchialgia. MATERIALS AND METHODS: All patients planned for laproscopic renal surgery between Jan 2009 and July 2011 had a history and physical examination before surgery, in postoperative period, and after discharge. Pain was scored on a standard 10-point scale approved by the NIH. Baseline, perioperative, and postoperative data were collected prospectively. RESULTS: A total of 460 laproscopic renal surgeries were performed on males out of which 440 met our criteria of evaluation. A total of 38 patients had ipsilateral orchialgia (8.52 %). The pain was more common for left-sided procedures. Mean pain intensity was 3.2. On statistical analysis, there was no difference in the operative parameters between patients of pain and those without pain except that the level of ligation of ureter and that of gonadal vein were significantly associated with orchialgia (p value <0.001 and 0.003, respectively) with the odds ratio for ligating them below the crossing of iliac vessels being 6.443 (3.098-13.397) and 4.457 (2.165-9.176), respectively. CONCLUSION:Ipsilateral orchialgia is common in patients undergoing laproscopic renal surgery specially after radical nephroureterectomy and nephrectomy specially when the ureter and gonadal vein are taken down at or below their crossing of iliac vessels. Taking down ureter above, rather than below, the iliac vessels whenever possible may be preventive as is the preservation of gonadal vein.
Authors: Li-Ming Su; Lloyd E Ratner; Robert A Montgomery; Thomas W Jarrett; Bruce J Trock; Vladimir Sinkov; Rachel Bluebond-Langner; Louis R Kavoussi Journal: Ann Surg Date: 2004-08 Impact factor: 12.969
Authors: Sompol Permpongkosol; Richard E Link; Li-Ming Su; Frederico R Romero; Herman S Bagga; Christian P Pavlovich; Thomas W Jarrett; Louis R Kavoussi Journal: J Urol Date: 2007-02 Impact factor: 7.450
Authors: R V Clayman; L R Kavoussi; N J Soper; S M Dierks; S Meretyk; M D Darcy; F D Roemer; E D Pingleton; P G Thomson; S R Long Journal: J Urol Date: 1991-08 Impact factor: 7.450
Authors: S P Shirodkar; M A Gorin; J Sageshima; V G Bird; J M Martinez; A Zarak; G Guerra; L Chen; G W Burke; G Ciancio Journal: Am J Transplant Date: 2011-05 Impact factor: 8.086
Authors: Fernando J Kim; Peter Pinto; Li Ming Su; Thomas W Jarrett; Lloyd E Rattner; Robert Montgomery; Louis R Kavoussi Journal: J Endourol Date: 2003-08 Impact factor: 2.942
Authors: Hany M El Hennawy; Abdullah S Al Faifi; Eisa Al Atta; Omar Safar; Saad Thamer; Weam El Nazer; Ahmed I Kamal; Abdelaziz A Abdelaziz; Shaher A Kawasmeh; Naveed Mirza; Mohammad F Zaitoun; Khalid Al-Alsheikh; Osama Shalkamy; Ahmed Mahedy Journal: Minim Invasive Surg Date: 2022-03-23