Chronic scrotal pain (CSP) is a common and debilitating condition, but the underlying characteristics and etiology of CSP are poorly understood. The objective of this study is to identify the characteristic and etiologies of CSP. Men presenting for management of CSP completed a standardized questionnaire and underwent a complete physical examination. From Feb 2014 to Sep 2015, a total of 131 men (mean age 43) with CSP were studied. The CSP was of long duration (mean of 4.7 ± 5.95 years) and dramatically affected men's lives, with adverse effects on normal activities (71.%), ability to work (51.90%), and sexual functioning (61.8%). 50.4% felt depressed on most days, and 67.17% felt either unhappy or terrible with their present condition. Physical examination revealed that the epididymis was the most common tender area found in 70/131 men (53.43%), though a musculoskeletal source for the pain was found in 9.9%. Neuropathic changes were found in 30%. For close to half of the men (43.5%) we were unable to identify any potential cause for the CSP. This study characterizes the dramatic impact that CSP has on the lives of men, while providing an understanding of the common etiologies.
We studied case-fatality rates (CFRs) among cases of meningococcal disease (MCD) admitted to Makkah (Saudi Arabia) hospitals during the period 1988-97. Of 483 cases, 431 (89.2%) were due to strains of serogroup A, 31 (6.4%) to serogroup W135, 16 (3.3%) to serogroup C, and 5 (10%) to serogroup B. Eighty-one patients died (case fatality rate (CFR)) 16.8%, 95% CI 13.5%, 20.4%). The CFR in infections due to serogroup A strains was 14.8%, and for other serogroups it was 32.7% (95% CI 20.3%, 47.1%). The CFR of MCD due to N. meningitidis serogroup A increased steadily with age (P<0.05). Seeking first medical help at a foreign Hajj medical mission and being treated in a non-specialized hospital were associated with a higher case fatality rate.
Background: Chronic scrotal pain (CSP) is a common and often debilitating condition found in up to 4.75% of men. There is little written on the impact of CSP on men's lives. Aim: The aim of this study was to understand the impact of CSP on men's lives. Methods: Patients with CSP were prospectively asked to complete a comprehensive questionnaire, including questions on quality of life (QoL), activities, and mood. Results: The mean age of the 131 patients was 43 years. Pain was intermittent, with severe pain episodes (mean pain scores 7.2 ± 2 out of 10) affecting men on average 40% ± 30% of the time. Overall, 88/131 (67.17%) of patients responded that they felt "unhappy" or "terrible" with their present situation. More than 40% of patients complained of depressive symptoms more than half the days of the month. Normal activities were adversely affected, with 68/131 (51.90%) reporting limited ability to work, 93/131 (70.99%) patients reporting decreased physical activity, and 81/131 (61.83%) reporting decreased sexual activity. Comparing men with pain levels ≥ 7/10 vs. those with pain levels < 7/10, 47% (41/88) vs. 8.1% (3/37) reported that they felt "terrible," 40% (35/88) vs. 13% (5/38) had depressive feelings more than half the time, and 35% (28/80) vs. 16% (6/38) felt little pleasure doing things (P < 0.01 for all). Conclusion: Our study suggests that QoL, mood, and the ability to perform normal activities are profoundly disturbed in CSP patients and that the pain severity is directly related to QoL. RÉSUMÉContexte: La douleur scrotale chronique est une affection commune et souvent débilitante dont souffrent près de 4,75 % des hommes. Il y a peu d'écrits sur l'impact de la douleur scrotale chronique sur la vie des hommes. But: Comprendre l'impact de la douleur scrotale chronique sur la vie des hommes. Méthodes: On a demandé de manière prospective à des patients souffrant de douleur scrotale chronique de remplir un questionnaire détaillé comprenant des questions sur leur qualité de vie, leurs activités et leur humeur. Résultats: L'âge moyen des 131 patients était de 43 ans. La douleur était intermittente, comportait des épisodes de douleur intense (scores de la douleur moyens 7,2 +/-2 sur 10) et affectait les hommes 40 % +/-30 % du temps. Globalement, 88/131 (67,17 %) des patients ont répondu qu'ils se sentaient malheureux ou « horriblement mal » en raison de leur situation actuelle. Plus de 40 % des patients se sont plaints de symptômes de dépression plus de la moitié des jours du mois. Leurs activités habituelles étaient affectées négativement, alors que 68/131 (51,90 %) disaient avoir une capacité de travail limitée, que 93/131 (70,99 %) des patients signalaient une diminution de leur activité physique et que 81/131 (61,83 %) d'entre eux faisaient état d'une diminution de leur activité sexuelle. La comparaison des hommes qui avaient un niveau de douleur ≥ 7/10 à ceux qui avaient un niveau de douleur < 7/10 a révélé que 47 % d'entre eux (41/88) se sentaient « horriblement pas bien » contre 8,1 % (3/37), que 40 %...
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