Persistent orchialgia after laparoscopic living-donor nephrectomy: an underestimated complication requiring information adjustment

Pinar, Ugo; Pettenati, C.; Hurel, S.; Pietak, M.; Dariane, C.; Audenet, François; Legendre, Christophe; Розенберг, А.; Méjean, A.; Timsit, Marc‐Olivier

doi:10.1007/s00345-020-03228-6

Cited by 4 publications

(10 citation statements)

References 21 publications

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“…The incidence of post-LDN ipsilateral testicular discomfort ranges from 1% of 381 patients [ 12 ], 3% of 70 patients [ 13 ], 2.2% of 20 patients [ 14 ], 6.2% of 129 patients [ 15 ], 8.5% of 440 patients [ 8 ], 9.6% of 145 patients [ 2 ], 26.1% of 20 patients [ 9 ], and 50% of 20 patients [ 7 ]. In this cohort, 15% of our LESS DN patients had ipsilateral testicular pain.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, gonadal vein ligation has been linked to testicular vascular congestion and pain [ 7 ]. Additionally, it has been proposed that orchialgia and hydrocele are caused by an interruption in lymphatic drainage [ 7 , 9 , 17 ]. Sureka et al suggested that the probability of orchialgia would be increased if the surrounding fatty tissue (which may contain neural fibers) was entrapped during gonadal vein and ureter clipping [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Postoperative pain is often underestimated [ 18 ], as lesser than half of patients (41.7%) suffering from testicular symptoms sought medical advice [ 9 ]. Similarly, 8.3% of post-LESS DN patients in this study population sought medical advice.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with post-LDN testicular discomfort should have a medical evaluation. Doppler ultrasonography may be performed based on pain characteristics and a physical examination [ 9 ]. Only six individuals in our study underwent transscrotal ultrasonography, which revealed no abnormalities.…”

Section: Discussionmentioning

confidence: 99%

“…Generally, pneumothorax, bleeding, and wound care issues are the most prevalent complications with open nephrectomy [ 1 – 5 ]. Despite being relatively safer, previous studies highlighted the association of LDN with ipsilateral testicular pain [ 2 , 6 , 7 ], with an incidence ranging from 8% to 44% of donors [ 6 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Post-Laparoendoscopic Single-Site Donor Nephrectomy Ipsilateral Testicular Pain, Does Operative Technique Matter? A Single Center Experience and Review of Literature

Hennawy

Faifi

Atta

et al. 2022

Minimally Invasive Surgery

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Aim. To assess incidence and characteristics of post-laparoendoscopic single-site donor nephrectomy (LESS DN) testicular pain. Materials and Methods. A prospective comparative study of all male donors post-left LESS DN (group A) vs. postopen nephrectomies (group B) was performed at our center. Patients’ demographics, perioperative data, and postoperative consultation reports were reviewed. Testicular pain, swelling, numbness, urinary symptoms, and sexual dysfunction were evaluated. Patients with a history of scrotal pathology or surgical procedure were excluded. Pain and tenderness were scored on a standard 10-point scale. Results. From September 2017 to December 2020, 85 and 35 male patients of groups A and B met the evaluation criteria. Ipsilateral testicular pain developed in 11 patients (15.3%) and 2 patients (9.5%) in groups A and B, respectively. In most instances, the pain was mild to moderate in severity, started after 6 ± 2.1 and 4 ± 1.1 days postoperatively in groups A and B, respectively. Six patients in group A were evaluated with transscrotal ultrasonography that showed no abnormalities. All patients in both groups responded well to medical treatment. Conclusions. Post-LESS DN ipsilateral testicular pain is usually mild and self-limited. Preoperative patient education and discussion of the possibility of development of testicular pain and its management should be an integral component of laparoscopic donor nephrectomy informed consent.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Post-Laparoendoscopic Single-Site Donor Nephrectomy Ipsilateral Testicular Pain, Does Operative Technique Matter? A Single Center Experience and Review of Literature

Hennawy

Faifi

Atta

et al. 2022

Minimally Invasive Surgery

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Testicular Pain Following Laparoscopic Donor Nephrectomy: An Underreported Complication

Choi,

Moon,

Kim

et al. 2024

Journal of Endourology

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Orchialgia After Living Donor Nephrectomy: An Underreported Entity

Schoephoerster¹,

Matas²,

Jackson³

et al. 2022

Transplantation Direct

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Background. Laparoscopic donor nephrectomy (LDN) offers advantages to the donor. The reported incidence of testicular pain after LDN varies in the literature ranging from 3% to 55%. Methods. A survey was sent to 322 male LDN patients who donated from February 5, 2009, to February 5, 2019. The survey assessed if the donor had testicular pain or saw an additional medical professional after donation. Results. Of the 322 surveyed, 147 (46%) responses were received. Of those who had a left nephrectomy, 39% had testicular pain; 23.8% of those patients had testicular swelling in addition. Of those who had pain, laterality of kidney donated did not impact if the patient had pain, pain onset, pain level, or pain duration. Of those who donated their right kidney, 35% had testicular pain, and 16.7% of those patients reported testicular swelling in addition. Twenty-seven symptomatic patients sought additional medical care for the testicular symptoms postdonation. Seven (25%) had hydroceles, 2 (7%) had testicular cysts, 1 had a urinary tract infection, and 16 (59%) had reassurance or no additional procedures provided. Conclusions. Our results suggest that orchialgia is not as uncommon as previously thought and may be one of the most common minor complications experienced by male donors.

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Persistent orchialgia after laparoscopic living-donor nephrectomy: an underestimated complication requiring information adjustment

Cited by 4 publications

References 21 publications

Post-Laparoendoscopic Single-Site Donor Nephrectomy Ipsilateral Testicular Pain, Does Operative Technique Matter? A Single Center Experience and Review of Literature

Post-Laparoendoscopic Single-Site Donor Nephrectomy Ipsilateral Testicular Pain, Does Operative Technique Matter? A Single Center Experience and Review of Literature

Testicular Pain Following Laparoscopic Donor Nephrectomy: An Underreported Complication

Orchialgia After Living Donor Nephrectomy: An Underreported Entity

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